NPI 1033895602

Ryan Blake Pridemore, LATATC

Practitioner Athletic Trainer Las Cruces, NM

Practice location

Address: 5700 Mesa Grande Dr, Las Cruces, NM 88011-6017
Phone: (423) 312-1031
Mailing address: 3402 Bixler Dr APT 2202, Las Cruces, NM 88012-5114

Registered specialties (2)

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence AT-2024-0006 (NM)

Other Specialist/Technologist providers in New Mexico →

Athletic Trainer

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence AT9424 (TX)

Registry record

NPI: 1033895602
Entity type: Individual
Sex (as registered): Male
NPI issued: 27 Jun 2023
Record last updated: 10 Jun 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.