Provider Demographics
NPI:1225412406
Name:SYMANIETZ, RYAN DALE (PA-C)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:DALE
Last Name:SYMANIETZ
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:2545 CHICAGO AVE
Mailing Address - Street 2:SUITE 601
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-4522
Mailing Address - Country:US
Mailing Address - Phone:612-863-7770
Mailing Address - Fax:612-863-7772
Practice Address - Street 1:2545 CHICAGO AVE
Practice Address - Street 2:SUITE 601
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-4522
Practice Address - Country:US
Practice Address - Phone:612-863-7770
Practice Address - Fax:612-863-7772
Is Sole Proprietor?:No
Enumeration Date:2015-07-16
Last Update Date:2023-04-12
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant