Provider Demographics
NPI:1215370622
Name:RUANO, MOLLY E (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:E
Last Name:RUANO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4626 BRADFORD RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-3851
Mailing Address - Country:US
Mailing Address - Phone:216-262-6927
Mailing Address - Fax:
Practice Address - Street 1:555 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2289
Practice Address - Country:US
Practice Address - Phone:619-260-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-16
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070019578282N00000X
CA296772225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No282N00000XHospitalsGeneral Acute Care Hospital