Provider Demographics
NPI:1770453599
Name:OCEAN, RYAN (LMT)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:OCEAN
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 33RD AVE N APT 2
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29577-2941
Mailing Address - Country:US
Mailing Address - Phone:404-401-8991
Mailing Address - Fax:
Practice Address - Street 1:4025 N KINGS HWY STE 18
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577-2740
Practice Address - Country:US
Practice Address - Phone:843-444-9095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-06
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11283225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist