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General NPI Number Information
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NPI Number | 1689605255
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Entity Type | Individual
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Provider Name | LORI L. WOOLISON RUTTER D.O.
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Gender | Female
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 03/09/2022
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Provider Practice Location Address
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Address Line | 75 HOSPITAL DR STE 350
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City | ATHENS
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State | OH
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Zip | 45701-2867
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Country | US
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Telephone | 740-592-7040
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Fax | 740-592-7041
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Provider Business Mailing Address
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Address Line | PO BOX 7527
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City | DUBLIN
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State | OH
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Zip | 43017-0727
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Country | US
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Telephone |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 34 008738
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License Number State | OH
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