Individual
NICOLE RAE RUOTSINOJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
967 S LAKE ST, FOREST LAKE, MN 55025
(651) 464-1113
(651) 464-0853
Mailing address
967 S LAKE ST, FOREST LAKE, MN 55025
(651) 464-1113
(651) 464-0853
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
282PIGO
BCBS
MN
Enumeration date
09/20/2006
Last updated
07/08/2007
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