Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ryan Diederich

Individual provider Physical Therapy Assistant · NPI 1104236108

Ryan Diederich is a Physical Therapy Assistant in Fort Wayne, Indiana. Practices as a sole proprietor. Licensed in Indiana.

Licensed in
IN
In the registry since
2014

Practice location Address checks out

2827 Northgate Blvd
Fort Wayne, IN 46835-2900
Phone: (260) 490-1400
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 06004770A (IN)

Record details

NPI number1104236108
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 30, 2014
Last updated in NPPESApril 30, 2014
Mailing address302 Union Station Dr, Fort Wayne, IN 46814-8964

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