Individual
MRS. GINALYN LACSON RUDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
401 CORPORATE PARK DR, SAINT LOUIS, MO 63105-4201
(314) 725-7447
Mailing address
4977 SEIBERT AVE, AFFTON, MO 63123-4736
(314) 287-0757
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.018896
IL
225100000X
Physical Therapist
2012009718
MO
Other
Enumeration date
02/10/2012
Last updated
04/12/2017
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