Provider Demographics
NPI:1689015448
Name:FLATT, RYAN (DPT)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:FLATT
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 E MAIN ST STE D
Mailing Address - Street 2:
Mailing Address - City:LANDER
Mailing Address - State:WY
Mailing Address - Zip Code:82520-3424
Mailing Address - Country:US
Mailing Address - Phone:307-335-3471
Mailing Address - Fax:307-332-5388
Practice Address - Street 1:535 E MAIN ST STE D
Practice Address - Street 2:
Practice Address - City:LANDER
Practice Address - State:WY
Practice Address - Zip Code:82520-3424
Practice Address - Country:US
Practice Address - Phone:307-335-3471
Practice Address - Fax:307-332-5388
Is Sole Proprietor?:No
Enumeration Date:2013-07-09
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYPT-1485225100000X, 2251X0800X
WYWY-14852251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY135764600Medicaid
WYW25697Medicare UPIN