Provider Demographics
NPI:1780931782
Name:JESCHIEN, RYAN J (DPT)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:J
Last Name:JESCHIEN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8541 E ANDERSON DR
Mailing Address - Street 2:STE 100
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-5430
Mailing Address - Country:US
Mailing Address - Phone:480-585-6810
Mailing Address - Fax:480-585-6910
Practice Address - Street 1:8541 E ANDERSON DR
Practice Address - Street 2:STE 100
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-5430
Practice Address - Country:US
Practice Address - Phone:480-585-6810
Practice Address - Fax:480-585-6910
Is Sole Proprietor?:No
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ9859225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist