Individual
JUSTIN B RYDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
280 EXEMPLA CIR, LAFAYETTE, CO 80026-3370
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2906
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
024332
KAISER COMMERCIAL NUMBER
CO
05
—
53881826
—
CO
Enumeration date
10/26/2009
Last updated
06/08/2021
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