Provider Demographics
NPI:1407515133
Name:HOLMGAARD, RUEGER J
Entity Type:Individual
Prefix:MR
First Name:RUEGER
Middle Name:J
Last Name:HOLMGAARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N CENTER ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51449-1031
Mailing Address - Country:US
Mailing Address - Phone:712-297-4352
Mailing Address - Fax:
Practice Address - Street 1:600 N CENTER ST
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:IA
Practice Address - Zip Code:51449-1031
Practice Address - Country:US
Practice Address - Phone:712-297-4352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-09
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Single Specialty