Individual
DR. MARK DERUITER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
164 PILLSBURY DR SE, 115 SHEVLIN HALL, MINNEAPOLIS, MN 55455-0279
(612) 624-5755
(612) 624-7586
Mailing address
164 PILLSBURY DR SE, MINNEAPOLIS, MN 55455-0279
(612) 624-5755
(612) 624-7586
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
5987
MN
Other
Enumeration date
07/06/2007
Last updated
09/06/2007
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