Provider Demographics
NPI:1811294259
Name:NAYLOR, ANDREW RYAN (DPT)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:RYAN
Last Name:NAYLOR
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 1:744 S WEBSTER AVE
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54301-3505
Mailing Address - Country:US
Mailing Address - Phone:920-445-7226
Mailing Address - Fax:920-445-7229
Practice Address - Street 1:500 E BUSINESS WAY
Practice Address - Street 2:SUITE C
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-2374
Practice Address - Country:US
Practice Address - Phone:513-354-3700
Practice Address - Fax:513-389-3665
Is Sole Proprietor?:No
Enumeration Date:2011-02-22
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13712-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist