Provider Demographics
NPI:1891068433
Name:SHEPLER, RYAN PATRICK (PTA)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:PATRICK
Last Name:SHEPLER
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6015 POINTE WEST BLVD
Mailing Address - Street 2:COASTAL ORTHOPEDICS AND SPORTS MEDICINE, ATTN CREDENTIA
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-5542
Mailing Address - Country:US
Mailing Address - Phone:941-792-1404
Mailing Address - Fax:941-296-7662
Practice Address - Street 1:6015 POINTE WEST BLVD
Practice Address - Street 2:COASTAL ORTHOPEDICS AND SPORTS MEDICINE, ATTN CREDENTIA
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-5542
Practice Address - Country:US
Practice Address - Phone:941-792-1404
Practice Address - Fax:941-296-7662
Is Sole Proprietor?:No
Enumeration Date:2012-02-13
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA22220225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant