Individual
MR. JASON CONRAD RUSZNAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2390 NATIONAL RD W, RICHMOND, IN 47374-4625
(765) 939-4871
(765) 962-8273
Mailing address
2390 NATIONAL RD W, RICHMOND, IN 47374-4625
(765) 939-4871
(765) 962-8273
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05010412A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000336580
ANTHEM BC/BS
OH
Enumeration date
07/22/2006
Last updated
02/10/2015
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