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NPI Code Detail

MEDICARE: MS. ELIZABETH ANN RUCH OTD, OTR/L

MEDICARE: MS. ELIZABETH ANN RUCH OTD, OTR/L
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 Therapist1103NE

General Provider Information

NPI Number : 1508045782
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELIZABETH ANN RUCH OTD, OTR/L
Provider Business Mailing Address
First Line : 100 INDIAN HILLS DR.
Second Line :
City : MACY
State : NE
Zip : 68039
Country : US
Telephone Number : 402-837-4190
Fax Number : 402-837-5303
Provider Business Practice Location Address
First Line : 1665 COCHRANE CIR
Second Line :
City : FT CARSON
State : CO
Zip : 80913-4603
Country : US
Telephone Number : 719-524-2647
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2007
Last Update Date : 10/25/2019

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