Healthcare Provider Details

I. General information

NPI: 1104783471
Provider Name (Legal Business Name): RYLIE BROTHERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 3RD ST NW
JAMESTOWN ND
58401-2963
US

IV. Provider business mailing address

2200 20TH ST SW
JAMESTOWN ND
58401-7500
US

V. Phone/Fax

Practice location:
  • Phone: 701-840-3534
  • Fax:
Mailing address:
  • Phone: 701-952-5142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-2840894
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: