Individual
ERICK IAN RUTAQUIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2944 ALLISTER ST, DALLAS, TX 75229-2459
(945) 546-3791
Mailing address
2944 ALLISTER ST, DALLAS, TX 75229-2459
(945) 546-3791
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
124811
TX
Other
Enumeration date
01/10/2025
Last updated
01/10/2025
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