Provider Demographics
NPI:1497425995
Name:RUEFER, KATHERINE LYNN (PTA)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LYNN
Last Name:RUEFER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 VALLEY RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:BLUE GRASS
Mailing Address - State:IA
Mailing Address - Zip Code:52726-9802
Mailing Address - Country:US
Mailing Address - Phone:563-508-8629
Mailing Address - Fax:
Practice Address - Street 1:304 SW 12TH ST
Practice Address - Street 2:
Practice Address - City:ALEDO
Practice Address - State:IL
Practice Address - Zip Code:61231-2707
Practice Address - Country:US
Practice Address - Phone:309-582-5376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant