Provider Demographics
NPI:1710530944
Name:RUSTIGAN CHIROPRACTIC INC
Entity Type:Organization
Organization Name:RUSTIGAN CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:RUSTIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:559-897-5801
Mailing Address - Street 1:1374 SMITH ST
Mailing Address - Street 2:
Mailing Address - City:KINGSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:93631-2217
Mailing Address - Country:US
Mailing Address - Phone:559-897-5801
Mailing Address - Fax:559-897-9134
Practice Address - Street 1:1374 SMITH ST
Practice Address - Street 2:
Practice Address - City:KINGSBURG
Practice Address - State:CA
Practice Address - Zip Code:93631-2217
Practice Address - Country:US
Practice Address - Phone:559-897-5801
Practice Address - Fax:559-897-9134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-17
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty