Provider Demographics
NPI:1518789288
Name:PERRIN, RYAN
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:PERRIN
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 1:427 CENTRAL AVE W
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59404-2846
Mailing Address - Country:US
Mailing Address - Phone:406-781-5218
Mailing Address - Fax:
Practice Address - Street 1:427 CENTRAL AVE W
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59404-2846
Practice Address - Country:US
Practice Address - Phone:406-781-5218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-24
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT98016-2020-00000135343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)