Individual
MR. RYAN BEINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3801 SPRING ST, RACINE, WI 53405-1667
(262) 687-4201
Mailing address
3805B SPRING ST, SUITE 230, RACINE, WI 53405-1641
(262) 687-4479
(262) 687-5375
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1367-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1367-023
STATE LICENSE
WI
Enumeration date
07/04/2006
Last updated
07/09/2007
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