Individual
RYAN NUTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
525 W RIVER WOODS PKWY # 201, MILWAUKEE, WI 53212-1024
(414) 249-2422
(414) 249-0298
Mailing address
525 W RIVER WOODS PKWY STE 130, GLENDALE, WI 53212-1010
(414) 961-0304
(414) 961-0298
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
2773-023
WI
Other
Enumeration date
10/04/2011
Last updated
03/03/2021
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