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NPI Code Detail

MEDICARE: MR. BARRY K RUTT PT

MEDICARE:  MR. BARRY K RUTT  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
1225100000XPhysical Therapist1854NE

General Provider Information

NPI Number : 1336341171
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BARRY K RUTT PT
Provider Business Mailing Address
First Line : 1354 PRAIRIE VIEW RD
Second Line :
City : EAGLE
State : NE
Zip : 68347-7037
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1600 SOUTH 48TH STREET
Second Line :
City : LINCOLN
State : NE
Zip : 68506-1299
Country : US
Telephone Number : 402-481-8672
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2007
Last Update Date : 07/08/2007

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Directions to “ MR. BARRY K RUTT PT” Practice Location

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