Provider Demographics
NPI:1710466255
Name:HORVATH, RYAN DENNIS (MS PT, ATC)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:DENNIS
Last Name:HORVATH
Suffix:
Gender:M
Credentials:MS PT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 INNOVATION PKWY STE 135
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-3602
Mailing Address - Country:US
Mailing Address - Phone:317-884-5200
Mailing Address - Fax:
Practice Address - Street 1:1260 INNOVATION PKWY STE 135
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-3602
Practice Address - Country:US
Practice Address - Phone:317-884-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05008002A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist