Provider Demographics
NPI:1245887876
Name:DURANT, RYAN (ATC, MELAT, NHLAT)
Entity type:Individual
Prefix:MR
First Name:RYAN
Middle Name:
Last Name:DURANT
Suffix:
Gender:M
Credentials:ATC, MELAT, NHLAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 POST RD
Mailing Address - Street 2:
Mailing Address - City:GREENLAND
Mailing Address - State:NH
Mailing Address - Zip Code:03840-2313
Mailing Address - Country:US
Mailing Address - Phone:603-583-0991
Mailing Address - Fax:
Practice Address - Street 1:44 GREENOUGH RD
Practice Address - Street 2:
Practice Address - City:PLAISTOW
Practice Address - State:NH
Practice Address - Zip Code:03865-2724
Practice Address - Country:US
Practice Address - Phone:603-583-0991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-19
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH06792255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer