Provider Demographics
NPI:1760716880
Name:COLE, RUTH ANN (HHP, ABT, MT)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:ANN
Last Name:COLE
Suffix:
Gender:F
Credentials:HHP, ABT, MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:667 PALM AVE STE B
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:91932-1243
Mailing Address - Country:US
Mailing Address - Phone:619-392-0883
Mailing Address - Fax:
Practice Address - Street 1:667 PALM AVE STE B
Practice Address - Street 2:
Practice Address - City:IMPERIAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:91932-1243
Practice Address - Country:US
Practice Address - Phone:619-392-0883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-22
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist