Provider Demographics
NPI:1336341171
Name:RUTT, BARRY K (PT)
Entity Type:Individual
Prefix:MR
First Name:BARRY
Middle Name:K
Last Name:RUTT
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 1:1354 PRAIRIE VIEW RD
Mailing Address - Street 2:
Mailing Address - City:EAGLE
Mailing Address - State:NE
Mailing Address - Zip Code:68347-7037
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1600 SOUTH 48TH STREET
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-1299
Practice Address - Country:US
Practice Address - Phone:402-481-8672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1854225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist