Provider Demographics
NPI:1659399228
Name:TUTTLE, DOUGLAS GLENN (RKT)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:GLENN
Last Name:TUTTLE
Suffix:
Gender:M
Credentials:RKT
Other - Prefix:
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Mailing Address - Street 1:486 OTTER LN N
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-8362
Mailing Address - Country:US
Mailing Address - Phone:561-422-7746
Mailing Address - Fax:561-422-8288
Practice Address - Street 1:7305 N MILITARY TRL
Practice Address - Street 2:
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33410-7417
Practice Address - Country:US
Practice Address - Phone:561-422-7746
Practice Address - Fax:561-422-8288
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist