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Individual

RYAN J THORESON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
405 MONROE ST, PELLA, IA 50219-1189
(641) 628-3832
(641) 628-8894
Mailing address
405 MONROE ST, PELLA, IA 50219-1189
(641) 628-3832
(641) 628-8894

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
3379
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0739201
IA
01
35014
WELLMARK
IA
Enumeration date
08/12/2006
Last updated
10/17/2007
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