Organization
INNOVATIVE TREATMENT ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN RULISON MD (MEDICAL DIRECTOR)
(530) 391-9196
Entity
Organization
Contact information
Practice address
3581 PALMER DR STE 601, CAMERON PARK, CA 95682-8238
(530) 556-5363
Mailing address
3116 CASTLEWOOD CIR, POLLOCK PINES, CA 95726-9522
(530) 391-9309
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
03/17/2019
Last updated
04/04/2019
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