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General NPI Number Information
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NPI Number | 1194941476
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Entity Type | Individual
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Provider Name | CORINNE RUTTIGER A.T.,C.
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Gender | Female
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 18350 NW 67TH AVE
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City | HIALEAH
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State | FL
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Zip | 33015-3403
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Country | US
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Telephone | 305-557-3770
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Fax | 305-827-8896
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Provider Business Mailing Address
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Address Line | 6436 NW 170TH TER
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City | HIALEAH
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State | FL
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Zip | 33015-4600
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Country | US
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Telephone | 305-823-5044
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AL 394
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License Number State | FL
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