Provider Demographics
NPI:1992371306
Name:SCROGGINS, RYAN DANIEL (DPT)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:DANIEL
Last Name:SCROGGINS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 HIGDON FERRY RD STE G
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-6904
Mailing Address - Country:US
Mailing Address - Phone:501-525-2273
Mailing Address - Fax:501-525-1773
Practice Address - Street 1:1635 HIGDON FERRY RD STE G
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6904
Practice Address - Country:US
Practice Address - Phone:501-525-2273
Practice Address - Fax:501-525-1773
Is Sole Proprietor?:No
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4941225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR4941OtherARKANSAS STATE BOARD OF PHYSICAL THERAPY