| Doctor Name: | RYAN SANDERS GARY |
| NPI Number: | 1003247891 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT, DPT |
| License Number: | PTL.0012446 |
| Business Practice Address: | 1331 Lake Dr Se Suite 105 Grand Rapids, MI - 495061674 |
| Business Phone Number: | 6162489842 |
| Business Fax Number: | 6162489848 |
| Mailing Address: | 1331 Lake Dr Se, Suite 105 GRAND RAPIDS |
| State: | MI |
| Postal Code: | 495061674 |
| Phone Number: | 6162489842 |
| Fax Number: | 6162489848 |
| NPI Enumeration Date: | 12/05/2013 |
| NPI Last Update Date: | 11/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PTL.0012446 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CO |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |