Provider Demographics
NPI:1548014335
Name:RUIZ, JOSEPH CONNOR (DPT)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:CONNOR
Last Name:RUIZ
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4310 JOHNS CREEK PKWY STE 130
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6092
Mailing Address - Country:US
Mailing Address - Phone:770-757-3058
Mailing Address - Fax:
Practice Address - Street 1:4310 JOHNS CREEK PKWY STE 130
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-6092
Practice Address - Country:US
Practice Address - Phone:770-692-1481
Practice Address - Fax:770-495-0806
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports