Individual
RUTH J. TIFFAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1202 5TH GRANT BLVD, WABASHA, MN 55981-1042
(651) 565-4571
Mailing address
1202 5TH GRANT BLVD, WABASHA, MN 55981-1042
(651) 565-4571
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
41252
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
995319100
—
MN
Enumeration date
01/24/2006
Last updated
11/10/2020
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