Individual
RUBY ISALY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
560 E HOWARD AVENUE, DRIGGS, ID 83422
(406) 220-9075
Mailing address
PO BOX 3443, ALPINE, WY 83128-0443
(406) 220-9075
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
06/18/2014
Last updated
06/18/2014
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