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Individual

DR. RYAN S SYVRUD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
825 25TH ST S, FARGO, ND 58103-8724
(701) 237-5150
(701) 532-1211
Mailing address
825 25TH ST S, FARGO, ND 58103-8724
(701) 237-5150
(701) 532-1211

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
497
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
16342
ND
01
26293
BLUE CROSS BLUE SHIELD ND
ND
01
63140SY
BLUE CROSS BLUE SHIELD MN
MN
05
653528300
MN
01
N715762
MEDICARE
ND
Enumeration date
09/26/2006
Last updated
04/13/2016
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