Provider Demographics
NPI:1033327937
Name:RUETZ, PATTY (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:PATTY
Middle Name:
Last Name:RUETZ
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1298 HIGHWAY 14
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:67439-8662
Mailing Address - Country:US
Mailing Address - Phone:785-472-2560
Mailing Address - Fax:
Practice Address - Street 1:1298 HIGHWAY 14
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:KS
Practice Address - Zip Code:67439-8662
Practice Address - Country:US
Practice Address - Phone:785-472-2560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-01118225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist