Provider Demographics
NPI:1942992516
Name:KASPRZAK, RYAN
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:KASPRZAK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5788 DEE DR
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-7332
Mailing Address - Country:US
Mailing Address - Phone:614-937-4266
Mailing Address - Fax:
Practice Address - Street 1:10401 SAWMILL PKWY STE B
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-7451
Practice Address - Country:US
Practice Address - Phone:380-390-4540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT020403225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist