Provider Demographics
NPI:1922560028
Name:ORIGER, RYAN
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:ORIGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1748 HOOVER TRAIL CIR SW
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-7492
Mailing Address - Country:US
Mailing Address - Phone:515-890-0682
Mailing Address - Fax:
Practice Address - Street 1:1045 N GRAND AVE
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:IA
Practice Address - Zip Code:52641-3111
Practice Address - Country:US
Practice Address - Phone:319-385-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-05
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA22527183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist