Provider Demographics
NPI:1982926333
Name:RUHLE, DARANA LOUISE (ATC LAT)
Entity Type:Individual
Prefix:
First Name:DARANA
Middle Name:LOUISE
Last Name:RUHLE
Suffix:
Gender:F
Credentials:ATC LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:829 WINGINA AVE
Mailing Address - Street 2:MANTEO HIGH SCHOOL
Mailing Address - City:MANTEO
Mailing Address - State:NC
Mailing Address - Zip Code:27954-9103
Mailing Address - Country:US
Mailing Address - Phone:252-473-5841
Mailing Address - Fax:252-473-2263
Practice Address - Street 1:829 WINGINA AVE
Practice Address - Street 2:MANTEO HIGH SCHOOL
Practice Address - City:MANTEO
Practice Address - State:NC
Practice Address - Zip Code:27954-9103
Practice Address - Country:US
Practice Address - Phone:252-473-5841
Practice Address - Fax:252-473-2263
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC04772255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer