Provider Demographics
NPI:1659973212
Name:CAMARENA, RUBY NAOMI (LMT)
Entity Type:Individual
Prefix:
First Name:RUBY
Middle Name:NAOMI
Last Name:CAMARENA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 N BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-3847
Mailing Address - Country:US
Mailing Address - Phone:913-309-2885
Mailing Address - Fax:
Practice Address - Street 1:541 N BELMONT AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-3847
Practice Address - Country:US
Practice Address - Phone:913-309-2885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist