Healthcare Provider Details

I. General information

NPI: 1952309205
Provider Name (Legal Business Name): JOHN GEORGE RUTSCH DC, PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2005
Last Update Date: 01/13/2021
Certification Date: 01/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13661 43RD AVE
CHIPPEWA FALLS WI
54729-6741
US

IV. Provider business mailing address

13661 43RD AVE
CHIPPEWA FALLS WI
54729-6741
US

V. Phone/Fax

Practice location:
  • Phone: 715-933-1567
  • Fax:
Mailing address:
  • Phone: 715-933-1567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2896
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20096
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: