Healthcare Provider Details

I. General information

NPI: 1669720025
Provider Name (Legal Business Name): SARAH LAUREN RUTHENBURG DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2012
Last Update Date: 08/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 CROSSLAKE DR
EVANSVILLE IN
47715-8198
US

IV. Provider business mailing address

23 TURTLE CREEK DR
ASHEVILLE NC
28803-3152
US

V. Phone/Fax

Practice location:
  • Phone: 812-477-1558
  • Fax: 812-474-2296
Mailing address:
  • Phone: 828-274-2188
  • Fax: 828-274-7843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP13722
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: