Provider Demographics
NPI:1811352958
Name:RUTSCHILLING, TIFFANY (ATC)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:RUTSCHILLING
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 N WOODVIEW DR
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:OH
Mailing Address - Zip Code:45828-1031
Mailing Address - Country:US
Mailing Address - Phone:419-305-6174
Mailing Address - Fax:
Practice Address - Street 1:102 N WOODVIEW DR
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:OH
Practice Address - Zip Code:45828-1031
Practice Address - Country:US
Practice Address - Phone:419-305-6174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-16
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0036772255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer