Provider Demographics
NPI:1619584273
Name:RUTLEDGE, SYDNEE LAREE (DC)
Entity type:Individual
Prefix:MRS
First Name:SYDNEE
Middle Name:LAREE
Last Name:RUTLEDGE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MS
Other - First Name:SYDNEE
Other - Middle Name:LAREE
Other - Last Name:HUBBARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3634 MCCAIN RD STE 7
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49203-2576
Mailing Address - Country:US
Mailing Address - Phone:517-962-2178
Mailing Address - Fax:
Practice Address - Street 1:3634 MCCAIN RD STE 7
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-2576
Practice Address - Country:US
Practice Address - Phone:517-962-2178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010990111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor