| Doctor Name: | RONALD RUTTEN |
| NPI Number: | 1184097271 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | PT-433 |
| Business Practice Address: | 300 S 3rd W Soda Springs, ID - 832761559 |
| Business Phone Number: | 2085473341 |
| Business Fax Number: | 2085472790 |
| Mailing Address: | 1872 N Honeysuckle Ln, INKOM |
| State: | ID |
| Postal Code: | 832451612 |
| Phone Number: | 2087753531 |
| Fax Number: | |
| NPI Enumeration Date: | 11/11/2015 |
| NPI Last Update Date: | 11/11/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT-433 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |