Provider Demographics
NPI:1568964393
Name:HART, RUTHILDE GINER-VALDEZ
Entity Type:Individual
Prefix:
First Name:RUTHILDE
Middle Name:GINER-VALDEZ
Last Name:HART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12025 BYRNES ST
Mailing Address - Street 2:
Mailing Address - City:OSSINEKE
Mailing Address - State:MI
Mailing Address - Zip Code:49766-9783
Mailing Address - Country:US
Mailing Address - Phone:989-255-8081
Mailing Address - Fax:
Practice Address - Street 1:1501 W CHISHOLM ST
Practice Address - Street 2:
Practice Address - City:ALPENA
Practice Address - State:MI
Practice Address - Zip Code:49707-1401
Practice Address - Country:US
Practice Address - Phone:989-356-7248
Practice Address - Fax:989-356-8078
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-07
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501008256225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist