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Individual

DEE WAYNE RUTHERFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LAT

Contact information

Practice address
3211 47TH ST, LUBBOCK, TX 79413-4112
(806) 766-0705
(806) 766-0509
Mailing address
4115 62ND DR, LUBBOCK, TX 79413-5115
(806) 766-0705
(806) 766-0509

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0969
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
22
PROVIDER
TX
Enumeration date
08/01/2007
Last updated
08/01/2007
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