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NPI Code Detail

MEDICARE: LARS CHRISTIAN RUSER

MEDICARE:   LARS CHRISTIAN RUSER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistMI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619536471
Entity Type Code : Individual
Provider Name (Legal Business Name) : LARS CHRISTIAN RUSER
Provider Business Mailing Address
First Line : 839 WICKFORD DR
Second Line :
City : KALAMAZOO
State : MI
Zip : 49009-7975
Country : US
Telephone Number : 269-501-7762
Fax Number :
Provider Business Practice Location Address
First Line : 23332 RED ARROW HWY
Second Line :
City : MATTAWAN
State : MI
Zip : 49071-9703
Country : US
Telephone Number : 269-283-5345
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2019
Last Update Date : 06/06/2019

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Directions to “ LARS CHRISTIAN RUSER ” Practice Location

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