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NPI Code Detail

MEDICARE: MICHAEL RUTAR

MEDICARE: MICHAEL RUTAR
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
1225X00000XOccupational TherapistOTH-008107AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1OTH-008107OTHERAZARIZONA BOARD OF OCCUPATIONAL THERAPY EXAMINERS
2424259OTHERTHE NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY

General Provider Information

NPI Number : 1013589654
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL RUTAR
Provider Business Mailing Address
First Line : 1951 W CAMELBACK RD STE 450
Second Line :
City : PHOENIX
State : AZ
Zip : 85015-3474
Country : US
Telephone Number : 320-267-8360
Fax Number :
Provider Business Practice Location Address
First Line : 1951 W CAMELBACK RD STE 450
Second Line :
City : PHOENIX
State : AZ
Zip : 85015-3474
Country : US
Telephone Number : 320-267-8360
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2021
Last Update Date : 03/07/2025

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Directions to “ MICHAEL RUTAR ” Practice Location

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