Provider Demographics
NPI:1295179273
Name:RUFFO, MICHELLE LYNN (DPT)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LYNN
Last Name:RUFFO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:LYNN
Other - Last Name:MCGREGOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:434 W AARON DR
Mailing Address - Street 2:#104
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-3074
Mailing Address - Country:US
Mailing Address - Phone:814-235-9995
Mailing Address - Fax:
Practice Address - Street 1:2160 SANDY DR STE A
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-2282
Practice Address - Country:US
Practice Address - Phone:814-861-8122
Practice Address - Fax:814-861-4292
Is Sole Proprietor?:No
Enumeration Date:2013-04-22
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPA022666225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist