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General NPI Number Information
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NPI Number | 1316341381
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Entity Type | Individual
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Provider Name | PETER RYAN PHARM.D
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Gender | Male
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Dates
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Enumeration Date | 10/20/2014
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Last Update Date | 10/20/2014
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Provider Practice Location Address
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Address Line | 2323 HIGHWAY 3 S
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City | NORTHFIELD
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State | MN
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Zip | 55057-5172
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Country | US
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Telephone | 507-403-4140
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Fax |
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Provider Business Mailing Address
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Address Line | 1407 5TH ST SE
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City | NEW PRAGUE
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State | MN
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Zip | 56071-2452
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 22371
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License Number State | IA
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