Individual
GEORGIA RUOT MERRIFIELD
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
404 NE PENN AVE, BEND, OR 97701-4264
(541) 318-7041
(541) 388-3711
Mailing address
404 NE PENN AVE, BEND, OR 97701-4264
(541) 318-7041
(541) 388-3711
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4464
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
231986
—
OR
01
—
331489
PROVIDENCE
—
01
—
5512828
FIRST HEALTH
—
01
—
H254806
PACIFIC SOURCE
OR
Enumeration date
11/15/2005
Last updated
07/08/2007
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