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Individual

MR. CHARLES WALTER RUITER III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3355 PALMS CENTER DR, LAS VEGAS, NV 89103-5663
(702) 252-4069
Mailing address
3355 PALMS CENTER DR, LAS VEGAS, NV 89103-5663
(702) 252-4069

Taxonomy

Speciality
Code
Description
License number
State
225XE0001X
Environmental Modification Occupational Therapist
Primary
B202009141071371
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9005059132
NV
Enumeration date
08/23/2021
Last updated
08/23/2021
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