Most Relevant Information
Provider Data
| NPI Number: | 1003488826 |
| Provider Name: | MICHAEL RYAN |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 18333 |
Most Important Dates
| Enumeration Date: | 07/12/2021 |
| Last Updated: | 07/12/2021 |
Provider Practice Location
1141 N BROADWAY
COUNCIL BLUFFS
IA
515031513
Practice Location Phone/Fax
| Phone: | 7123229019 |
| Fax: | 7123259731 |
Provider Mailing Location
1141 N BROADWAY
COUNCIL BLUFFS
IA
515031513
Provider Mailing Phone/Fax
| Phone: | 7123229019 |
| Fax: | 7123259731 |