MEDICARE: MISS KAREN M RUTZ LPT

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	3799	OH

General Provider Information

NPI Number	:	1528515970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS KAREN M RUTZ LPT

Provider Business Mailing Address
First Line	:	4685 FOREST AVE
Second Line	:	STE C
City	:	CINCINNATI
State	:	OH
Zip	:	45212-3359
Country	:	US
Telephone Number	:	513-382-8897
Fax Number	:

Provider Business Practice Location Address
First Line	:	1326 WITTEKIND TER
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45224-2120
Country	:	US
Telephone Number	:	513-382-8897
Fax Number	:

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

Provider Enumeration Date	:	09/01/2016
Last Update Date	:	11/28/2016

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