Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 106741 | IA |
NPI | 1003408634 |
---|---|
Provider Name | Madison Mae Ruhland |
First Address | Des Moines, IA 50309-3321 |
Second Address | Des Moines, IA 50309-3321 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2021 |
Last Update Date | 04/02/2021 |