Provider Demographics
NPI:1508405861
Name:RUBNER, STUART DONALD (DC)
Entity Type:Individual
Prefix:
First Name:STUART
Middle Name:DONALD
Last Name:RUBNER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1804 BROADWAY ST STE 125
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-2686
Mailing Address - Country:US
Mailing Address - Phone:320-763-0313
Mailing Address - Fax:
Practice Address - Street 1:1804 BROADWAY ST STE 125
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-2686
Practice Address - Country:US
Practice Address - Phone:320-763-0313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-03
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6690111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor