Provider Demographics
NPI:1588625347
Name:NUTT, REX LYNN (PT)
Entity Type:Individual
Prefix:MR
First Name:REX
Middle Name:LYNN
Last Name:NUTT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 WINNERS CIR
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-5632
Mailing Address - Country:US
Mailing Address - Phone:325-691-5711
Mailing Address - Fax:325-695-1005
Practice Address - Street 1:1290 S WILLIS ST
Practice Address - Street 2:SUITE 211
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-4068
Practice Address - Country:US
Practice Address - Phone:325-668-7472
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1002681225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist