Healthcare Provider Details

I. General information

NPI: 1023935715
Provider Name (Legal Business Name): RUTH B MCDONALD LMT, MLD-C, CLT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3461 LAWRENCEVILLE SUWANEE RD STE B
SUWANEE GA
30024-6428
US

IV. Provider business mailing address

3461 LAWRENCEVILLE SUWANEE RD STE B
SUWANEE GA
30024-6428
US

V. Phone/Fax

Practice location:
  • Phone: 508-505-5289
  • Fax:
Mailing address:
  • Phone: 508-505-5289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT014642
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: