Healthcare Provider Details

I. General information

NPI: 1477238822
Provider Name (Legal Business Name): MEGAN ELIZABETH RUARK LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2023
Last Update Date: 06/21/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1335 US 68
MAYSVILLE KY
41056-9132
US

IV. Provider business mailing address

1532 TAYLOR MILL RD
FLEMINGSBURG KY
41041-7557
US

V. Phone/Fax

Practice location:
  • Phone: 606-564-4213
  • Fax:
Mailing address:
  • Phone: 859-200-1691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number107448
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: