Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 0007622 | CO |
N | 111NR0400X | Rehabilitation Chiropractor | 0007622 | CO |
NPI | 1639664964 |
---|---|
Provider Name | Dr. Mitchell Bruce Rasmussen |
First Address | Littleton, CO 80120-2280 |
Second Address | Littleton, CO 80120-2280 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2018 |
Last Update Date | 28/06/2018 |