1639980998 NPI number — MRS. ALISHA NICOLE RUHL AT, ATC

Table of content: MRS. ALISHA NICOLE RUHL AT, ATC (NPI 1639980998)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639980998 NPI number — MRS. ALISHA NICOLE RUHL AT, ATC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RUHL
Provider First Name:
ALISHA
Provider Middle Name:
NICOLE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
AT, ATC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HAYES
Provider Other First Name:
ALISHA
Provider Other Middle Name:
NICOLE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
AT, ATC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1639980998
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/16/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
651 W MARION RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOUNT GILEAD
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43338-1096
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-560-5028
Provider Business Mailing Address Fax Number:
419-949-3116

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7819 STATE ROUTE 19
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GALION
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44833-9654
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-560-5028
Provider Business Practice Location Address Fax Number:
419-946-5098
Provider Enumeration Date:
01/16/2025

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2255A2300X , with the licence number:  AT005372 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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