Provider Demographics
NPI:1205502952
Name:RYAN, MADISON DAWN (MEDICAL COSMETICS)
Entity type:Individual
Prefix:MRS
First Name:MADISON
Middle Name:DAWN
Last Name:RYAN
Suffix:
Gender:F
Credentials:MEDICAL COSMETICS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2738 TERRACE BLVD
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41102-6156
Mailing Address - Country:US
Mailing Address - Phone:606-547-2231
Mailing Address - Fax:
Practice Address - Street 1:841 29TH ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-3019
Practice Address - Country:US
Practice Address - Phone:606-547-2231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-20
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZA2600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherArt, Medical