Individual
MR. ETHAN RUTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
356 PEBBLE LN, RATLIFF CITY, OK 73481-8058
(580) 465-0164
Mailing address
356 PEBBLE LN, RATLIFF CITY, OK 73481-8058
(580) 465-0164
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/17/2013
Last updated
07/17/2013
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