Provider Demographics
NPI:1467714212
Name:TARUC, ELOISA DELA CRUZ (PT, DPT)
Entity Type:Individual
Prefix:MISS
First Name:ELOISA
Middle Name:DELA CRUZ
Last Name:TARUC
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 1:3886 BROADVIEW LN
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28056-8380
Mailing Address - Country:US
Mailing Address - Phone:704-964-8272
Mailing Address - Fax:
Practice Address - Street 1:3886 BROADVIEW LN
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28056-8380
Practice Address - Country:US
Practice Address - Phone:704-964-8272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP11404225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist