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General NPI Number Information
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NPI Number | 1194990101
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Entity Type | Organization
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Legal Business Name | DR. RUANTO'S CLINIC
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Dates
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Enumeration Date | 04/30/2008
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Last Update Date | 04/30/2008
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Provider Practice Location Address
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Address Line | 104 OLD JEFFERSON STREET
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City | CELINA
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State | TN
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Zip | 38551-0347
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Country | US
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Telephone | 931-243-4176
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Fax | 931-243-4641
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Provider Business Mailing Address
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Address Line | PO BOX 347 104 OLD JEFFERSON STREET
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City | CELINA
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State | TN
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Zip | 38551-0347
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Country | US
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Telephone | 931-243-4176
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Fax | 931-243-4641
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Authorized Official
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Title or Position | PRESIDENT
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Name | ARTURO N RUANTO
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Credential | MD
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Telephone | 931-243-4176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 13102
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License Number State | TN
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