Provider Demographics
NPI:1013154491
Name:FISCHER, RYAN ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:ROBERT
Last Name:FISCHER
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 1:2801 S WAYZATA BLVD
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55405-2125
Mailing Address - Country:US
Mailing Address - Phone:612-353-4486
Mailing Address - Fax:
Practice Address - Street 1:3300 EDINBOROUGH WAY
Practice Address - Street 2:SUITE 108
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-5923
Practice Address - Country:US
Practice Address - Phone:920-915-3913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-07
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5166111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor