Individual
PAMELA RUTAQUIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
6301 GASTON AVE STE 750, DALLAS, TX 75214-6339
(214) 295-5374
Mailing address
13907 MONTFORT DR APT 1325, DALLAS, TX 75240-7354
(615) 618-6606
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
1205881
TX
Other
Enumeration date
06/10/2019
Last updated
06/10/2019
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