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Individual

RYAN WICHT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
9664 63RD AVE N, MAPLE GROVE, MN 55369-6200
(763) 504-0395
(612) 295-0022
Mailing address
9664 63RD AVE N, MAPLE GROVE, MN 55369-6200

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6134
MN

Other

Enumeration date
11/13/2015
Last updated
12/10/2018
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