Provider Demographics
NPI:1730878182
Name:GUTZKY, RYAN ROBERT (MHA, ATC, AT)
Entity type:Individual
Prefix:MR
First Name:RYAN
Middle Name:ROBERT
Last Name:GUTZKY
Suffix:
Gender:M
Credentials:MHA, ATC, AT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 ELM ST
Mailing Address - Street 2:
Mailing Address - City:WALBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43465-1136
Mailing Address - Country:US
Mailing Address - Phone:216-318-4211
Mailing Address - Fax:
Practice Address - Street 1:108 ELM ST
Practice Address - Street 2:
Practice Address - City:WALBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43465-1136
Practice Address - Country:US
Practice Address - Phone:216-318-4211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer