John, Duane Rudolph
John, Duane Rudolph is an sole proprietor health care provider with primary practice located at 4535 Hodgson Rd , Shoreview MN 55126-1949. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. John, Duane Rudolph can be contacted via phone (651) 490-1507.Contact Information
Primary practice address
4535 Hodgson Rd
Shoreview MN 55126-1949
Phone: (651) 490-1507
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 2834 | Minnesota |
Profile Details
| NPI number | 1215055348 |
|---|---|
| LBN Legal business name | John, Duane Rudolph |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 27th, 2007 |
| Last updated | Feb 28th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215055348 | NPPES |
| Minnesota | MEDICAID | 126828700 |
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