Provider Demographics
NPI:1730634494
Name:RYDER, LEAH
Entity type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:
Last Name:RYDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18686 STORE LN
Mailing Address - Street 2:
Mailing Address - City:SPRING RUN
Mailing Address - State:PA
Mailing Address - Zip Code:17262-9715
Mailing Address - Country:US
Mailing Address - Phone:717-977-2498
Mailing Address - Fax:
Practice Address - Street 1:18686 STORE LN
Practice Address - Street 2:
Practice Address - City:SPRING RUN
Practice Address - State:PA
Practice Address - Zip Code:17262-9715
Practice Address - Country:US
Practice Address - Phone:717-977-2498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-23
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife