Basic Information
| Provider Information | |||||||||
| NPI: | 1730383027 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TOWNSEND | ||||||||
| FirstName: | RYAN | ||||||||
| MiddleName: | JOSEPH | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | M.S., ATC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6041 MERIDIAN DR | ||||||||
| Address2: | #425 | ||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685041090 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4027427869 | ||||||||
| FaxNumber: | 4024881172 | ||||||||
| Practice Location | |||||||||
| Address1: | 575 S 70TH ST | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685102471 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024883322 | ||||||||
| FaxNumber: | 4024881172 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2255A2300X | 380 | NE | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer |
No ID Information.