Individual
MRS. MICHELLE LYNN RUTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR L
Contact information
Practice address
S JUNE SMITH CENTER, 600 EDEN RD BUILDING I, LANCASTER, PA 17601-4205
(717) 299-4829
(717) 295-3453
Mailing address
725 S STATE ST, EPHRATA, PA 17522-2343
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OC009636
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013948890001
17
PA
Enumeration date
03/14/2007
Last updated
07/08/2007
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