Individual
MIRANDA RAY RUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1600 N 2ND ST, CLINTON, MO 64735-1192
(660) 885-5511
Mailing address
5209 S NORFLEET RD, INDEPENDENCE, MO 64055-5672
(712) 310-5335
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2023009278
MO
Other
Enumeration date
06/21/2023
Last updated
06/21/2023
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