Individual
TRACY DAWN RUDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.M.T.
Contact information
Practice address
1061 109TH AVE NE, SUITE D, BLAINE, MN 55434-3846
(763) 208-4562
Mailing address
3065 165TH LN NE, HAM LAKE, MN 55304-5107
(612) 275-2761
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
MN
Other
Enumeration date
11/03/2010
Last updated
11/03/2010
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