Individual
MRS. RUTH ANN FEDOR BURNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.T.
Contact information
Practice address
80 MADDEX DR, SHEPHERDSTOWN, WV 25443-4305
(304) 876-9422
(304) 876-6869
Mailing address
83 VERONICA LN, CHARLES TOWN, WV 25414-4150
(540) 539-7420
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
002132
WV
225100000X
Physical Therapist
2305202943
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002132
WV PT LICENSE
WV
01
—
2305202943
VA PT LICENSE
VA
01
—
N 252291218-8
HPSO LIABILITY INSURANCE
—
Enumeration date
03/17/2007
Last updated
02/12/2017
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