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Audrey Ryan

Physical Therapist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

22 Masonic Ave, Wallingford, CT 06492-3048

PECOS Enrollment

Based on the most recent information from CMS, provider Audrey Ryan does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1518348226
Provider Type
Individual
Full Name
Ryan, Audrey
Credential
DPT

Gender
Female
Sole Proprietor
No
Enumeration Date
6/18/2015
Last Updated
5/21/2020

Contact Information

Practice Location

22 Masonic Ave, Wallingford, CT 06492-3048

(203) 679-6273

Unlisted Fax

Mailing Location

22 Masonic Ave, Wallingford, CT 06492-3048

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 225100000X Primary	Description Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers	License 10225 Connecticut

Provider Identifiers

ID	Description	Issuer
ID 10225	Description Other	Issuer CT PRACTICE LICENSE Connecticut

Audrey Ryan

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Pratt, Kevin

Bronson, Austin

Macaro, Merle

Olko, Alexa

Randall, Lauren

Warren, Elizabeth Anne Saia

Filosa, Kelli

Kane, Olivia

Bowman, Karen

Prohealth Physicians Physical Therapy