Provider Demographics
NPI:1124506951
Name:RITTMASTER, KIMBERLY HULLSIEK (DC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:HULLSIEK
Last Name:RITTMASTER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:LYNN
Other - Last Name:HULLSIEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16190 HIGHWAY 7
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-3403
Mailing Address - Country:US
Mailing Address - Phone:952-582-1172
Mailing Address - Fax:
Practice Address - Street 1:16190 HIGHWAY 7
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-3403
Practice Address - Country:US
Practice Address - Phone:952-582-1172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-02
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6532111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor