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Individual

MR. IVAN RUIZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ORTHOTIST

Contact information

Practice address
9690 VANTANA WAY, JOHNS CREEK, GA 30022-6394
(404) 833-8737
(770) 751-0961
Mailing address
12460 CRABAPPLE RD, SUITE 202-336, ALPHARETTA, GA 30004-6602
(404) 833-8737
(770) 751-0961

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
51
GA

Other

Enumeration date
07/22/2007
Last updated
10/31/2007
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