Healthcare Provider Details

I. General information

NPI: 1366355547
Provider Name (Legal Business Name): CRISTINA MARIE LUGO RUIZ DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5627 NW 86TH ST STE 200
JOHNSTON IA
50131-2605
US

IV. Provider business mailing address

333 E 10TH ST APT 332
DUBUQUE IA
52001-7620
US

V. Phone/Fax

Practice location:
  • Phone: 515-270-0303
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number130104
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: