Provider Demographics
NPI:1265400279
Name:KRACH, RYAN THOMAS (ATC)
Entity type:Individual
Prefix:MR
First Name:RYAN
Middle Name:THOMAS
Last Name:KRACH
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 JOHN A MERRITT BLVD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-1500
Mailing Address - Country:US
Mailing Address - Phone:571-535-5979
Mailing Address - Fax:
Practice Address - Street 1:3500 JOHN A MERRITT BLVD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-1500
Practice Address - Country:US
Practice Address - Phone:615-963-7829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0104020702255A2300X
TN17532255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer