Provider Demographics
NPI:1881029676
Name:FAKER, RYAN CHRISTOPHER (PT)
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:CHRISTOPHER
Last Name:FAKER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2670 MILLS PARK DR
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-8599
Mailing Address - Country:US
Mailing Address - Phone:803-324-3745
Mailing Address - Fax:803-324-9845
Practice Address - Street 1:2670 MILLS PARK DR
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-8599
Practice Address - Country:US
Practice Address - Phone:803-324-3745
Practice Address - Fax:803-324-9845
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-11
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8926225100000X
SC4533225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist