MEDICARE: RYAN KARJALAHTI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171WH0202X	Home Modifications Contractor	BC807605	MN

General Provider Information

NPI Number	:	1205799392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN KARJALAHTI

Provider Business Mailing Address
First Line	:	4147 38TH AVE S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55406-3426
Country	:	US
Telephone Number	:	612-708-8998
Fax Number	:

Provider Business Practice Location Address
First Line	:	4147 38TH AVE S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55406-3426
Country	:	US
Telephone Number	:	612-708-8998
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2025
Last Update Date	:	12/04/2025

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