Provider Demographics
NPI:1740258607
Name:RYALS, EMBER (PT)
Entity type:Individual
Prefix:DR
First Name:EMBER
Middle Name:
Last Name:RYALS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:NOT
Other - Middle Name:
Other - Last Name:APPLICABLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:655 7TH ST BLDG 700A
Mailing Address - Street 2:78 MDG/SGOFY
Mailing Address - City:ROBINS AFB
Mailing Address - State:GA
Mailing Address - Zip Code:31098-2227
Mailing Address - Country:US
Mailing Address - Phone:487-327-7798
Mailing Address - Fax:487-327-7799
Practice Address - Street 1:MADIGAN ARMY MEDICAL CENTER
Practice Address - Street 2:9040 JACKSON AVE
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431
Practice Address - Country:US
Practice Address - Phone:253-968-2252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist