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NPI Code Detail

MEDICARE: DR. RYAN CHRISTOPHER REILLY D.C.

MEDICARE:  DR. RYAN CHRISTOPHER REILLY  D.C.
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
1111N00000XChiropractor5398MN

General Provider Information

NPI Number : 1689994626
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RYAN CHRISTOPHER REILLY D.C.
Provider Business Mailing Address
First Line : 4833 MINNETONKA BLVD
Second Line :
City : ST LOUIS PARK
State : MN
Zip : 55416-2214
Country : US
Telephone Number : 952-913-8786
Fax Number : 952-922-2335
Provider Business Practice Location Address
First Line : 4833 MINNETONKA BLVD
Second Line :
City : ST LOUIS PARK
State : MN
Zip : 55416-2214
Country : US
Telephone Number : 952-913-8786
Fax Number : 952-922-2335
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2010
Last Update Date : 06/11/2012

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Directions to “ DR. RYAN CHRISTOPHER REILLY D.C.” Practice Location

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