Healthcare Provider Details

I. General information

NPI: 1518887512
Provider Name (Legal Business Name): RUTA BARDAUSKAITE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 SAINT MARY RD
VALPARAISO IN
46383-3986
US

IV. Provider business mailing address

725 S 19TH ST
CHESTERTON IN
46304-2700
US

V. Phone/Fax

Practice location:
  • Phone: 219-286-3700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: