Provider Demographics
NPI:1508173972
Name:PUTNEY, RUTH ELIZABETH (PT)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:ELIZABETH
Last Name:PUTNEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1558 CASTLE RD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:NY
Mailing Address - Zip Code:13416-2616
Mailing Address - Country:US
Mailing Address - Phone:315-891-3018
Mailing Address - Fax:
Practice Address - Street 1:106 MEMORIAL PKWY
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-4818
Practice Address - Country:US
Practice Address - Phone:315-368-6018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011184-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist