Provider Demographics
NPI:1164918603
Name:RUFINO, GENYL (PT)
Entity Type:Individual
Prefix:
First Name:GENYL
Middle Name:
Last Name:RUFINO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14585 MANCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MO
Mailing Address - Zip Code:63011-3963
Mailing Address - Country:US
Mailing Address - Phone:314-941-3970
Mailing Address - Fax:314-931-1352
Practice Address - Street 1:14585 MANCHESTER RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MO
Practice Address - Zip Code:63011-3963
Practice Address - Country:US
Practice Address - Phone:314-941-3970
Practice Address - Fax:314-931-1352
Is Sole Proprietor?:No
Enumeration Date:2018-07-09
Last Update Date:2022-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT294996225100000X
MO2019011728225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist