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General NPI Number Information
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NPI Number | 1265602809
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Entity Type | Organization
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Legal Business Name | RULIN J. HAWKS, PT, PLLC
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Dates
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Enumeration Date | 03/11/2008
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Last Update Date | 03/11/2008
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Provider Practice Location Address
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Address Line | 1902 S 10TH AVE
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City | CALDWELL
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State | ID
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Zip | 83605-4841
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Country | US
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Telephone | 208-453-9111
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Fax | 208-453-9115
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Provider Business Mailing Address
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Address Line | 1902 S 10TH AVE
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City | CALDWELL
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State | ID
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Zip | 83605-4841
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Country | US
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Telephone | 208-453-9111
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Fax | 208-453-9115
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Authorized Official
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Title or Position | OWNER
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Name | MR. RULIN J. HAWKS
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Credential | P.T.
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Telephone | 208-453-9111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT1122
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License Number State | ID
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