Provider Demographics
NPI:1083128425
Name:OSTER, RYAN JOHN (DC)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:JOHN
Last Name:OSTER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 2ND AVE SW
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MN
Mailing Address - Zip Code:55008-1502
Mailing Address - Country:US
Mailing Address - Phone:763-689-2462
Mailing Address - Fax:763-689-1688
Practice Address - Street 1:137 2ND AVE SW
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MN
Practice Address - Zip Code:55008
Practice Address - Country:US
Practice Address - Phone:763-689-2462
Practice Address - Fax:763-689-1688
Is Sole Proprietor?:No
Enumeration Date:2017-11-21
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6522111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor