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Individual

MRS. PATRICIA LYNN RUTKA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.M.T.

Contact information

Practice address
21 DONALD B. DEAN DRIVE, S. PORTLAND, ME 04106
(207) 874-9859
Mailing address
21 DONALD B. DEAN DRIVE, S. PORTLAND, ME 04106
(207) 874-9859
(207) 874-9859

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT1190
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
350439700
US DEPT OF LABOR FEDERAL
Enumeration date
11/12/2009
Last updated
11/12/2009
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