MEDICARE: DR. JAMI RAYMOND RASSMUSSEN D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	5440	MN

General Provider Information

NPI Number	:	1568770931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMI RAYMOND RASSMUSSEN D.C.

Provider Business Mailing Address
First Line	:	1981 INCA LN
Second Line	:
City	:	NEW BRIGHTON
State	:	MN
Zip	:	55112-3143
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6776 LAKE DR
Second Line	:	SUITE 210
City	:	LINO LAKES
State	:	MN
Zip	:	55014-1191
Country	:	US
Telephone Number	:	651-262-5292
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2010
Last Update Date	:	12/22/2010

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