Individual
MS. RUBY DIANE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
95-1011 PUUKOA ST, MILILANI, HI 96789-6505
(863) 409-5465
Mailing address
95-1011 PUUKOA ST, MILILANI, HI 96789-6505
(863) 409-5465
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 18427
FL
Other
Enumeration date
05/03/2007
Last updated
01/16/2008
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