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NPI Code Detail

MEDICARE: RYAN T NESS DPT

MEDICARE: RYAN T NESS DPT
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
1225100000XPhysical Therapist11476MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1100672OTHERMNOPTUM (UNITED HEALTH CARE)

General Provider Information

NPI Number : 1881255248
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN T NESS DPT
Provider Business Mailing Address
First Line : 7825 3RD ST N STE 105
Second Line :
City : OAKDALE
State : MN
Zip : 55128-5444
Country : US
Telephone Number : 952-835-4512
Fax Number : 888-425-0398
Provider Business Practice Location Address
First Line : 5400 FRANCE AVE S
Second Line :
City : EDINA
State : MN
Zip : 55410-2356
Country : US
Telephone Number : 952-835-4512
Fax Number : 888-425-0398
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2019
Last Update Date : 07/19/2021

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