Provider Demographics
NPI:1861968778
Name:CABALLERO-GALIA, RULEVIA D (LPT)
Entity type:Individual
Prefix:
First Name:RULEVIA
Middle Name:D
Last Name:CABALLERO-GALIA
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1641 BROOKDALE DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-5008
Mailing Address - Country:US
Mailing Address - Phone:734-507-0047
Mailing Address - Fax:
Practice Address - Street 1:29270 MORLOCK ST
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-2044
Practice Address - Country:US
Practice Address - Phone:248-476-0550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-17
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501005096225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist