Provider Demographics
NPI:1528356268
Name:RUTHERFORD, SHILOH R (PT)
Entity Type:Individual
Prefix:
First Name:SHILOH
Middle Name:R
Last Name:RUTHERFORD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SHILOH
Other - Middle Name:R
Other - Last Name:HOWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 CRESCENT CENTRE DR STE 600
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-7286
Mailing Address - Country:US
Mailing Address - Phone:615-373-1350
Mailing Address - Fax:615-221-9054
Practice Address - Street 1:2005 AVALON AVE
Practice Address - Street 2:
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661-3188
Practice Address - Country:US
Practice Address - Phone:256-415-5111
Practice Address - Fax:256-415-5112
Is Sole Proprietor?:No
Enumeration Date:2011-07-15
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9015225100000X
ALPTH7446225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist