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NPI 1184380982

NPI 1184380982 : ERIC RUTHIG LMT : NASHVILLE, TN

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General NPI Number Information
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    NPI Number           |    1184380982
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    Entity Type          |    Individual 
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    Provider Name        |    ERIC RUTHIG LMT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/16/2021
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    Last Update Date     |    11/16/2021
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Provider Practice Location Address
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    Address Line         |    1530 RIVERSIDE DR 
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    City                 |    NASHVILLE
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    State                |    TN
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    Zip                  |    37206-1440
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    Country              |    US
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    Telephone            |    312-809-0809
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6319 CHARLOTTE PIKE APT F8 
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    City                 |    NASHVILLE
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    State                |    TN
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    Zip                  |    37209-2955
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    Country              |    US
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    Telephone            |    312-809-0809
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225700000X
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    Taxonomy Name        |    Massage Therapist
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    License Number       |    13802
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    License Number State |    TN
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