Provider Demographics
NPI:1992092845
Name:KLINGBEIL, RYAN ALLEN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:ALLEN
Last Name:KLINGBEIL
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 1:13577 6TH ST N
Mailing Address - Street 2:
Mailing Address - City:WEST LAKELAND
Mailing Address - State:MN
Mailing Address - Zip Code:55082-1912
Mailing Address - Country:US
Mailing Address - Phone:612-501-3007
Mailing Address - Fax:
Practice Address - Street 1:2199 HIGHWAY 36 E
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55109-2215
Practice Address - Country:US
Practice Address - Phone:651-779-6341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-29
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN119634183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist