Individual
RYAN IVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
35 STATE AVE, FARIBAULT, MN 55021-6368
(507) 497-3790
Mailing address
2005 JEFFERSON RD APT 207, NORTHFIELD, MN 55057-3196
(952) 807-5466
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11773
MN
Other
Enumeration date
02/06/2020
Last updated
02/06/2020
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