Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 57842 | MN |
NPI | 1215197793 |
---|---|
Provider Name | Ryan T Morgan |
First Address | Bloomington, MN 55431-4800 |
Second Address | Bloomington, MN 55431-4800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2008 |
Last Update Date | 17/12/2018 |