Provider Demographics
NPI:1679831580
Name:RYAN, JOHN C (CPHT)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:C
Last Name:RYAN
Suffix:
Gender:M
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7501 TRINITY PEAK ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-9035
Mailing Address - Country:US
Mailing Address - Phone:702-243-8730
Mailing Address - Fax:
Practice Address - Street 1:7501 TRINITY PEAK ST
Practice Address - Street 2:SUITE 210
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-9035
Practice Address - Country:US
Practice Address - Phone:702-243-8730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-27
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician