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Individual
SAMUEL JONATHAN RAKYTA II
Active
Individual
SAMUEL JONATHAN RAKYTA II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 012451
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
341877311-00
BWC
—
01
—
341877311030
CARESOURCE
OH
01
—
64-97047
UNITED HEALTHCARE
OH
Enumeration date
07/02/2009
Last updated
07/02/2009
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