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General NPI Number Information
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NPI Number | 1346594371
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Entity Type | Individual
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Provider Name | CARRIE A WERTH-RUDOLPH PT
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Gender | Female
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Dates
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Enumeration Date | 10/29/2012
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Last Update Date | 10/29/2012
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Provider Practice Location Address
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Address Line | 325 SPRING CREEK DR
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City | EUGENE
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State | OR
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Zip | 97404-1272
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Country | US
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Telephone | 541-688-3353
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Fax |
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Provider Business Mailing Address
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Address Line | 325 SPRING CREEK DR
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City | EUGENE
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State | OR
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Zip | 97404-1272
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Country | US
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Telephone | 541-688-3353
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 1221
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License Number State | OR
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