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Individual

RYAN MITTWEDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1141 HOSPITAL DR NW, CORYDON, IN 47112-2164
(812) 738-4251
Mailing address
13508 TERRACE CREEK DRIVE, APT 103, LOUISVILLE, KY 40245
(601) 291-3927

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
117229
KY

Other

Enumeration date
03/17/2017
Last updated
02/17/2021
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