Provider Demographics
NPI:1790019552
Name:HUGHES, RYAN TODD (DPT)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:TODD
Last Name:HUGHES
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 1:4854 BOAT LANDING DR
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32092-3693
Mailing Address - Country:US
Mailing Address - Phone:330-354-1394
Mailing Address - Fax:
Practice Address - Street 1:5836 RICHARD ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-5925
Practice Address - Country:US
Practice Address - Phone:904-306-9729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-28
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT25007225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist