Provider Demographics
NPI:1356591416
Name:RUTLEDGE, RUTHANN WEBER (ATC)
Entity type:Individual
Prefix:MRS
First Name:RUTHANN
Middle Name:WEBER
Last Name:RUTLEDGE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540A LINE RD
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-1634
Mailing Address - Country:US
Mailing Address - Phone:732-739-0800
Mailing Address - Fax:
Practice Address - Street 1:540A LINE RD
Practice Address - Street 2:
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1634
Practice Address - Country:US
Practice Address - Phone:732-739-0800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMT 000862255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer