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Individual

MR. LUKE BENNETT RYLANDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
4166 LEXINGTON AVE N, SHOREVIEW, MN 55126-6106
(651) 483-5461
Mailing address
PO BOX 43, MR 10860, MINNEAPOLIS, MN 55440-0043
(612) 262-1166
(612) 262-9035

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9702
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
374820100
MN
05
41956100
WI
Enumeration date
12/21/2005
Last updated
01/12/2023
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