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Individual

BRYAN RICHARD RUGGLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
956 TOURNAMENT TRL, WESTFIELD, IN 46074-6200
(317) 399-5004
Mailing address
625 ENTERPRISE DR, OAK BROOK, IL 60523-8813
(630) 575-1980

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05002771A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000092826
ANTHEM
IN
Enumeration date
05/31/2006
Last updated
04/27/2017
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