Individual
JILL HARRIET RUSTERHOLZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6565 FRANCE AVE S, SUITE 200, EDINA, MN 55435-2137
(952) 806-0011
(952) 806-9741
Mailing address
6565 FRANCE AVE S, SUITE 200, EDINA, MN 55435-2137
(952) 806-0011
(952) 806-9741
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25083
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
605307600
—
MN
Enumeration date
06/09/2005
Last updated
03/07/2016
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