MEDICARE: RUTH RICHARDS L.AC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	AC13986	CA

General Provider Information

NPI Number	:	1457632028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUTH RICHARDS L.AC.

Provider Business Mailing Address
First Line	:	11948 RIATA RD
Second Line	:
City	:	LOWER LAKE
State	:	CA
Zip	:	95457-9806
Country	:	US
Telephone Number	:	707-533-7086
Fax Number	:

Provider Business Practice Location Address
First Line	:	11948 RIATA RD
Second Line	:
City	:	LOWER LAKE
State	:	CA
Zip	:	95457-9806
Country	:	US
Telephone Number	:	707-533-7086
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2011
Last Update Date	:	02/08/2024

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