Healthcare Provider Details

I. General information

NPI: 1205704764
Provider Name (Legal Business Name): RUTH PADILLA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2025
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3125 SINTON RD APT 230
COLORADO SPRINGS CO
80907-5038
US

IV. Provider business mailing address

3125 SINTON RD APT 230
COLORADO SPRINGS CO
80907-5038
US

V. Phone/Fax

Practice location:
  • Phone: 719-504-3381
  • Fax:
Mailing address:
  • Phone: 719-504-3381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT.0025016
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: