Individual
KRISTI FREGIA RUCKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
775 POLE LINE RD W, TWIN FALLS, ID 83301-5814
(208) 814-2570
Mailing address
1225 KENYON RD, TWIN FALLS, ID 83301-5580
(715) 218-3515
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5353-024
WI
225100000X
Physical Therapist
Primary
5360
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871659748
—
WI
05
—
40267500
—
WI
Enumeration date
12/28/2006
Last updated
01/15/2019
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