Provider Demographics
NPI:1821369166
Name:RUSCIO, MICHAEL JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:RUSCIO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:43 QUAIL CT
Mailing Address - Street 2:BLDG 43 SUITE 107
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-4885
Mailing Address - Country:US
Mailing Address - Phone:925-705-7454
Mailing Address - Fax:925-478-3428
Practice Address - Street 1:43 QUAIL CT
Practice Address - Street 2:BLDG 43 SUITE 107
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-8701
Practice Address - Country:US
Practice Address - Phone:925-705-7454
Practice Address - Fax:925-478-3428
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-18
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA32079111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist