Provider Demographics
NPI:1558759860
Name:RUINARD, LEYTOCHA EVETTE (ND)
Entity Type:Individual
Prefix:DR
First Name:LEYTOCHA
Middle Name:EVETTE
Last Name:RUINARD
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9030 S MCCLINTOCK DR STE 105
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-4553
Mailing Address - Country:US
Mailing Address - Phone:602-628-8626
Mailing Address - Fax:
Practice Address - Street 1:9030 S MCCLINTOCK DR STE 105
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-4553
Practice Address - Country:US
Practice Address - Phone:602-628-8626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-08
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ13-1416175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath