Provider Demographics
NPI:1942860556
Name:SCORAN, RYAN THOMAS (PT DPT)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:THOMAS
Last Name:SCORAN
Suffix:
Gender:M
Credentials:PT DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:438 PELLIS RD STE 101
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-7900
Mailing Address - Country:US
Mailing Address - Phone:724-850-7587
Mailing Address - Fax:724-850-8329
Practice Address - Street 1:520 PELLIS RD STE 1000
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-4778
Practice Address - Country:US
Practice Address - Phone:724-838-1008
Practice Address - Fax:724-832-1690
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT027067225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1019541330001Medicaid