Individual
MICHAEL J RUTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MPAS, PA-C
Contact information
Practice address
1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236
(210) 292-4242
Mailing address
1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236-5638
(210) 292-4242
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
12/29/2006
Last updated
08/22/2018
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