Provider Demographics
NPI:1932486636
Name:HOLDEN, RYAN J (HEARING AID DISPENSE)
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:J
Last Name:HOLDEN
Suffix:
Gender:M
Credentials:HEARING AID DISPENSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W ROSEBURG AVE STE B2
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-5200
Mailing Address - Country:US
Mailing Address - Phone:209-287-3272
Mailing Address - Fax:209-287-3232
Practice Address - Street 1:200 W ROSEBURG AVE STE B2
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-5200
Practice Address - Country:US
Practice Address - Phone:209-287-3272
Practice Address - Fax:209-287-3232
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-08
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA7332237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist