Provider Demographics
NPI:1013055789
Name:NIEMI, RUTH AMANADA (DC)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:AMANADA
Last Name:NIEMI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6035 N COLLEGE
Mailing Address - Street 2:STE A
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704
Mailing Address - Country:US
Mailing Address - Phone:559-917-7736
Mailing Address - Fax:559-435-2436
Practice Address - Street 1:5612 NORTH BLACKSTONE AVENUE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710
Practice Address - Country:US
Practice Address - Phone:559-917-7736
Practice Address - Fax:559-435-2436
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25164111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor