Provider Demographics
NPI:1609259860
Name:DR. MARY RUTKOWSKI
Entity Type:Organization
Organization Name:DR. MARY RUTKOWSKI
Other - Org Name:CENTER VALLEY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:RUTKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-282-1722
Mailing Address - Street 1:5419 ROUTE 309
Mailing Address - Street 2:
Mailing Address - City:CENTER VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18034-9601
Mailing Address - Country:US
Mailing Address - Phone:610-282-1722
Mailing Address - Fax:610-282-0101
Practice Address - Street 1:5419 ROUTE 309
Practice Address - Street 2:
Practice Address - City:CENTER VALLEY
Practice Address - State:PA
Practice Address - Zip Code:18034-9601
Practice Address - Country:US
Practice Address - Phone:610-282-1722
Practice Address - Fax:610-282-0101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-07
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC3752-L111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty