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NPI Code Detail

MEDICARE: JACQUELYN MARIE RUEN DPT, OCS

MEDICARE: JACQUELYN MARIE RUEN DPT, OCS
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
12251X0800XOrthopedic Physical Therapist9265MN
22251X0800XOrthopedic Physical Therapist09309IA
32251X0800XOrthopedic Physical Therapist012636OH
4225100000XPhysical Therapist9265MN

General Provider Information

NPI Number : 1649437013
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELYN MARIE RUEN DPT, OCS
Provider Business Mailing Address
First Line : 7581 9TH ST N STE 100
Second Line :
City : OAKDALE
State : MN
Zip : 55128-6635
Country : US
Telephone Number : 651-748-4338
Fax Number :
Provider Business Practice Location Address
First Line : 1939 MINNEHAHA AVE W STE 100
Second Line :
City : SAINT PAUL
State : MN
Zip : 55104-1033
Country : US
Telephone Number : 651-348-7428
Fax Number : 651-348-7432
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2008
Last Update Date : 06/23/2021

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