Individual
DR. ALLEN KENNETH RYDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
200 THOMPSON AVE E, SAINT PAUL, MN 55118-3219
(651) 451-6839
(651) 451-2928
Mailing address
200 THOMPSON AVE E, WEST ST PAUL, MN 55118-3219
(651) 451-6839
(651) 451-2928
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3212
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
231904
ACN PROVIDER ID
MN
01
—
44-40114
MEDICA PROVIDER ID
MN
01
—
5C661RO
BLUE CROSS BLUE SHIELD ID
MN
Enumeration date
10/16/2006
Last updated
07/25/2023
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