Provider Demographics
NPI:1073495370
Name:LEVI, RYAN ALEXANDER
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:ALEXANDER
Last Name:LEVI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3489 FORESTDALE DR APT 2A
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-8223
Mailing Address - Country:US
Mailing Address - Phone:954-601-6745
Mailing Address - Fax:
Practice Address - Street 1:110 TWO HILLS DR
Practice Address - Street 2:
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-2675
Practice Address - Country:US
Practice Address - Phone:984-849-3597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP24025225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist