| Organization Name: | RYAN FERNS HEALTHPLEX |
| NPI Number: | 1336410711 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RYAN J FERNS (OWNER) |
| Mailing Address: | 100 Marshall St N Suite 2 Benwood |
| State: | WV US |
| Postal Code: | 260311013 |
| Phone Number: | 3042807133 |
| Fax Number: | |
| NPI Enumeration Date: | 01/18/2012 |
| NPI Last Update Date: | 06/03/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 002675 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |