Provider Demographics
NPI:1306044821
Name:FREEMAN, RUTH ANN (PT)
Entity Type:Individual
Prefix:MS
First Name:RUTH
Middle Name:ANN
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 BRYAN CAVE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH DAYTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32119-4405
Mailing Address - Country:US
Mailing Address - Phone:386-304-8624
Mailing Address - Fax:
Practice Address - Street 1:166 BRYAN CAVE RD
Practice Address - Street 2:
Practice Address - City:SOUTH DAYTONA
Practice Address - State:FL
Practice Address - Zip Code:32119-4405
Practice Address - Country:US
Practice Address - Phone:386-304-8624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 83242251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics