Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. RYAN L FAGAN, ATC LAT
ActiveMR. RYAN L FAGAN, ATC LAT is a Athletic Trainer healthcare provider located in CONVERSE, Indiana. NPI 1114991700 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · CONVERSE, IN
Registration Details
- NPI Number
- 1114991700
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 13, 2006 (20.456393468695 yrs)
- Last Updated
- Jul 8, 2007
- License
-
36000566A (IN)
Practice Information
- Address
-
7756 W. DELPHI PK.- 27CONVERSE, IN, 46919Browse IN providers · Browse ZIP 46919
- Phone
- 7653844381
- Fax
- 7653845414
- Primary Specialty
-
Athletic Trainer
2255A2300X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.