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General NPI Number Information
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NPI Number | 1326603234
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Entity Type | Individual
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Provider Name | RUTH GALANG MASHAK PT
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Gender | Female
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Dates
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Enumeration Date | 05/06/2019
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Last Update Date | 06/04/2021
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Provider Practice Location Address
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Address Line | 3691 N RHINE TRL
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City | LA PORTE
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State | IN
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Zip | 46350-8403
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Country | US
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Telephone | 219-448-9054
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Fax |
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Provider Business Mailing Address
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Address Line | 1007 LINCOLNWAY
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City | LA PORTE
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State | IN
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Zip | 46350-3290
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Country | US
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Telephone | 219-324-2397
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 05004901A
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License Number State | IN
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