MEDICARE: CARRIE R RUTLEDGE PT

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	1130714	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8T9272	OTHER	TX	BCBS
3	813T84	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1275652091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARRIE R RUTLEDGE PT

Provider Business Mailing Address
First Line	:	2960 ELDORADO PKWY
Second Line	:	SUITE 75
City	:	MCKINNEY
State	:	TX
Zip	:	75070-4373
Country	:	US
Telephone Number	:	972-562-0713
Fax Number	:	972-562-0932

Provider Business Practice Location Address
First Line	:	2960 ELDORADO PKWY
Second Line	:	SUITE 75
City	:	MCKINNEY
State	:	TX
Zip	:	75070-4373
Country	:	US
Telephone Number	:	972-562-0713
Fax Number	:	972-562-0932

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

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	10/20/2015

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Directions to “ CARRIE R RUTLEDGE PT” Practice Location

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