Basic Information
Provider Information
NPI: 1619334505
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RUHNKE
FirstName: LAUREN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
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Mailing Information
Address1: 1900 LONG PRAIRIE RD
Address2: SUITE 104
City: FLOWER MOUND
State: TX
PostalCode: 750224217
CountryCode: US
TelephoneNumber: 9727242400
FaxNumber: 9727242495
Practice Location
Address1: 2445 W OAK ST
Address2: SUITE 200
City: DENTON
State: TX
PostalCode: 762014325
CountryCode: US
TelephoneNumber: 9403206030
FaxNumber: 9403203113
Other Information
ProviderEnumerationDate: 01/22/2016
LastUpdateDate: 02/09/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X1271876TXY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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