Provider Demographics
NPI:1740520501
Name:PRYOR, RONALD J JR
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:J
Last Name:PRYOR
Suffix:JR
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 1:129 VENETIAN BAY CIR
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-7979
Mailing Address - Country:US
Mailing Address - Phone:302-270-8947
Mailing Address - Fax:321-421-1382
Practice Address - Street 1:1905 W STATE ROAD 434
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-6015
Practice Address - Country:US
Practice Address - Phone:321-418-3050
Practice Address - Fax:321-421-1382
Is Sole Proprietor?:No
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist
No224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist