Ryan Joe Wallace, RTR
Ryan Joe Wallace, RTR is a Body Imaging Physician in Moscow, Idaho. Practices as a sole proprietor. Licensed in Idaho.
- Licensed in
- ID
- In the registry since
- 2025
Practice location Address checks out
2500 W A St Ste 201Moscow, ID 83843-6000
Phone: (208) 596-8408
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Body Imaging Physician (primary) | Taxonomy 2085B0100X · Licence 386921 (ID) |
|---|
Record details
| NPI number | 1770370488 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | RTR |
| Sole proprietor | Yes |
| NPI enumerated | April 24, 2025 |
| Last updated in NPPES | April 24, 2025 |
| Certification date | April 24, 2025 |
| Mailing address | 2323 Charnita Dr, Clarkston, WA 99403-1429 |