Individual
LESLEY RUBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
840 ADDISON AVE, TWIN FALLS, ID 83301-5203
(208) 595-4941
(208) 595-4931
Mailing address
840 ADDISON AVE, TWIN FALLS, ID 83301-5203
(208) 595-4941
(208) 595-4931
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
OT-242
ID
225X00000X
Occupational Therapist
Primary
OT-242
ID
332BC3200X
Customized Equipment (DME)
OT-242
ID
Other
Enumeration date
12/20/2006
Last updated
09/24/2024
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