Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 15-0631 | NV |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 15-0631 | NV |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 15-0631 | NV |
NPI | 1932461985 |
---|---|
Provider Name | Mr. Eric Rutsky |
First Address | Las Vegas, NV 89146-1139 |
Second Address | Las Vegas, NV 89146-1139 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2012 |
Last Update Date | 24/03/2020 |