Basic Information
| Provider Information | |||||||||
| NPI: | 1255717542 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | BARRAGREE | ||||||||
| FirstName: | RYAN | ||||||||
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| Credential: | PT, DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 350 NEW FIDELITY CT | ||||||||
| Address2: | |||||||||
| City: | GARNER | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275292665 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9192582714 | ||||||||
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| Practice Location | |||||||||
| Address1: | 824 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | GARDNER | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660301287 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9133248680 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2015 | ||||||||
| LastUpdateDate: | 08/03/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 11-05217 | KS | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | P18954 | NC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.