Individual
JESSICA M CARRUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1415 WOODLAND AVE STE 140, DES MOINES, IA 50309-3203
(515) 241-4076
Mailing address
4920 30TH AVE S APT 104, FARGO, ND 58104-9025
(320) 368-3360
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
R-12523
IA
Other
Enumeration date
04/11/2022
Last updated
06/09/2023
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