Provider Demographics
NPI:1629273925
Name:RUTHERFORD, JOSEPH L
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:L
Last Name:RUTHERFORD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 133
Mailing Address - Street 2:349 RTE 7 SOUTH
Mailing Address - City:MILTON
Mailing Address - State:VT
Mailing Address - Zip Code:05468-0133
Mailing Address - Country:US
Mailing Address - Phone:802-893-1413
Mailing Address - Fax:802-893-2253
Practice Address - Street 1:349 ROUTE 7 S
Practice Address - Street 2:STE 105
Practice Address - City:MILTON
Practice Address - State:VT
Practice Address - Zip Code:05468-3877
Practice Address - Country:US
Practice Address - Phone:802-893-1413
Practice Address - Fax:802-893-2253
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist