Individual
SUSAN C RUCINSKI
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1234 WHITEFISH STAGE, KALISPELL, MT 59901-2753
(406) 756-7878
(406) 257-7811
Mailing address
1234 WHITEFISH STAGE, KALISPELL, MT 59901-2753
(406) 756-7878
(406) 257-7811
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
151PT
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0197808
WA STATE COMP PROVIDER #
MT
05
—
0349180
—
MT
01
—
61310
BCBS PROVIDER #
MT
01
—
MSF0076461
PROVIDER #
MT
Enumeration date
10/17/2005
Last updated
07/09/2007
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