Individual
TONY RUTHERFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASE MANAGER
Contact information
Practice address
112 SARTIN DR., EDMONTON, KY 42129
(270) 432-4951
(270) 432-5054
Mailing address
770 ROCKY HILL RD, COLUMBIA, KY 42728-8807
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
28004018
—
KY
Enumeration date
10/22/2007
Last updated
10/22/2007
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