MEDICARE: RUTH ANN COLE HHP, ABT, MT

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	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1760716880
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUTH ANN COLE HHP, ABT, MT

Provider Business Mailing Address
First Line	:	667 PALM AVE STE B
Second Line	:
City	:	IMPERIAL BEACH
State	:	CA
Zip	:	91932-1243
Country	:	US
Telephone Number	:	619-392-0883
Fax Number	:

Provider Business Practice Location Address
First Line	:	667 PALM AVE STE B
Second Line	:
City	:	IMPERIAL BEACH
State	:	CA
Zip	:	91932-1243
Country	:	US
Telephone Number	:	619-392-0883
Fax Number	:

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

Provider Enumeration Date	:	09/22/2009
Last Update Date	:	09/22/2009

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