MEDICARE: DR. PAMELA MIRIAM RUTSTEIN DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	5857	CO

General Provider Information

NPI Number	:	1013078849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAMELA MIRIAM RUTSTEIN DPT

Provider Business Mailing Address
First Line	:	6176 HOYT CT
Second Line	:
City	:	ARVADA
State	:	CO
Zip	:	80004-5367
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	780 DELAWARE ST
Second Line	:	WESTERN ADDITION, MC 0113
City	:	DENVER
State	:	CO
Zip	:	80204-4532
Country	:	US
Telephone Number	:	303-436-8570
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	07/08/2007

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