Healthcare Provider Details

I. General information

NPI: 1851310635
Provider Name (Legal Business Name): RYAN W NORLING D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 02/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1704 LEXINGTON AVE N
ROSEVILLE MN
55113-6514
US

IV. Provider business mailing address

1704 LEXINGTON AVE N
ROSEVILLE MN
55113-6514
US

V. Phone/Fax

Practice location:
  • Phone: 651-779-5998
  • Fax: 651-789-0809
Mailing address:
  • Phone: 651-779-5998
  • Fax: 651-789-0809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4076
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: