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General NPI Number Information
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NPI Number | 1720971351
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Entity Type | Individual
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Provider Name | LAUREN DESTINY RUBY
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Gender | Female
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 295 S 4TH ST STE 2
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City | HUNTINGDON
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State | PA
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Zip | 16652-1271
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Country | US
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Telephone | 814-347-5330
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Fax |
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Provider Business Mailing Address
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Address Line | 8340 GARLOCK RD
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City | MAPLETON DEPOT
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State | PA
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Zip | 17052-9507
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Country | US
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Telephone | 814-599-5230
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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 | PT033590
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License Number State | PA
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