Basic Information
Provider Information
NPI: 1457359283
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RUHL
FirstName: DAVID
MiddleName: E
NamePrefix:  
NameSuffix:  
Credential: P.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9600 BROADWAY EXT
Address2:  
City: OKLAHOMA CITY
State: OK
PostalCode: 731147408
CountryCode: US
TelephoneNumber: 4052309000
FaxNumber: 4052309175
Practice Location
Address1: 9600 BROADWAY EXT
Address2:  
City: OKLAHOMA CITY
State: OK
PostalCode: 731147408
CountryCode: US
TelephoneNumber: 4052309575
FaxNumber: 4052309585
Other Information
ProviderEnumerationDate: 07/14/2005
LastUpdateDate: 08/09/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2251X0800XPT946OKY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
2251S0007XAT56OKN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports

No ID Information.


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