Provider Demographics
NPI:1124336391
Name:MILBRANDT, RYAN W (PHARMD)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:W
Last Name:MILBRANDT
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 S GROVE ST
Mailing Address - Street 2:
Mailing Address - City:BLUE EARTH
Mailing Address - State:MN
Mailing Address - Zip Code:56013-2629
Mailing Address - Country:US
Mailing Address - Phone:507-526-2121
Mailing Address - Fax:
Practice Address - Street 1:405 S GROVE ST
Practice Address - Street 2:
Practice Address - City:BLUE EARTH
Practice Address - State:MN
Practice Address - Zip Code:56013-2629
Practice Address - Country:US
Practice Address - Phone:507-526-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-21
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN120040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist