Provider Demographics
NPI:1275380057
Name:WARD, RUBY MARIE (LMT)
Entity type:Individual
Prefix:
First Name:RUBY
Middle Name:MARIE
Last Name:WARD
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6763 WIMBLEDON DR
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077-9157
Mailing Address - Country:US
Mailing Address - Phone:865-300-9569
Mailing Address - Fax:
Practice Address - Street 1:301 E CARMEL DR STE C100
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-2890
Practice Address - Country:US
Practice Address - Phone:317-564-0930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN21405035225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist