Individual
RYAN J THORDAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
57950 LEAVENWORTH ST, MCCONNELL AFB, KS 67221-3506
(316) 759-5116
Mailing address
324 N EMPORIA AVE APT 321, WICHITA, KS 67202-2548
(218) 415-1462
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
253114
MA
208D00000X
General Practice Physician
Primary
57333
MN
Other
Enumeration date
07/17/2012
Last updated
04/12/2018
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