MEDICARE: DANNY JOE RUTZ DC PC

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	111N00000X	Chiropractor	B529	NV

General Provider Information

NPI Number	:	1750665378
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANNY JOE RUTZ DC PC

Provider Business Mailing Address
First Line	:	1420 S. JONES BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146
Country	:	US
Telephone Number	:	702-312-2225
Fax Number	:	702-312-2230

Provider Business Practice Location Address
First Line	:	1420 S. JONES BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146
Country	:	US
Telephone Number	:	702-312-2225
Fax Number	:	702-312-2230

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DANNY JOE RUTZ
Credential	:	D.C.
Telephone Number	:	702-312-2225

Provider Enumeration Date	:	09/30/2011
Last Update Date	:	10/18/2011

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