Individual
DR. JACK DOUGLAS RUSHIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
400 S 11TH ST, POPLAR BLUFF, MO 63901-5508
(573) 785-5666
Mailing address
400 S 11TH ST, POPLAR BLUFF, MO 63901-5508
(573) 785-5666
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
004561
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
752079806
—
MO
Enumeration date
10/25/2006
Last updated
01/09/2012
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