Individual
RUTH ANN ALLEN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1001 E 17TH ST, BLOOMINGTON, IN 47408-1590
(812) 855-1326
(812) 855-1810
Mailing address
1211 W 17TH ST, BLOOMINGTON, IN 47404-3021
(812) 333-9890
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36000644A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2255A2300X
ATHLETIC TRAINER
IN
Enumeration date
10/31/2005
Last updated
07/08/2007
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