Provider Demographics
NPI:1396039186
Name:COLOCAR, RUBY ANN CERCADO (LPT)
Entity Type:Individual
Prefix:MRS
First Name:RUBY ANN
Middle Name:CERCADO
Last Name:COLOCAR
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:763 SYLVESTER WAY
Mailing Address - Street 2:APARTMENT B6
Mailing Address - City:MCKEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15132-7722
Mailing Address - Country:US
Mailing Address - Phone:412-577-8949
Mailing Address - Fax:
Practice Address - Street 1:100 9TH ST # M
Practice Address - Street 2:
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15132-3952
Practice Address - Country:US
Practice Address - Phone:412-675-8724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT021101225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist