Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 2199 | MN |
NPI | 1003935438 |
---|---|
Provider Name | Dr. Cori L Rutchick |
First Address | St Paul, MN 55105 |
Second Address | St Paul, MN 55105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2007 |
Last Update Date | 08/07/2007 |