Provider Demographics
NPI:1144455700
Name:RYAN, JULIA FRANCES (RD)
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:FRANCES
Last Name:RYAN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:FRANCES
Other - Last Name:BORDNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:4235 SECOR RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4231
Mailing Address - Country:US
Mailing Address - Phone:419-740-1294
Mailing Address - Fax:888-363-3695
Practice Address - Street 1:4235 SECOR RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4231
Practice Address - Country:US
Practice Address - Phone:419-740-1294
Practice Address - Fax:888-363-3695
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-26
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD5139133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered