Provider Demographics
NPI:1265954580
Name:STRASSER, RYAN
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:STRASSER
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 1:3307 SKYLARK LN
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-7250
Mailing Address - Country:US
Mailing Address - Phone:715-351-0802
Mailing Address - Fax:
Practice Address - Street 1:2600 RIB MOUNTAIN DR STE 220
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-7196
Practice Address - Country:US
Practice Address - Phone:715-843-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-07
Last Update Date:2017-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13905-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist