Individual
MS. LARISSA R RUTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
115 WOODBINE LN, DANVILLE, PA 17822-5206
(570) 271-8050
Mailing address
100 N ACADEMY AVE, CREDENTIALS DEPT, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA056203
PA
Other
Enumeration date
07/10/2013
Last updated
07/10/2013
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