Provider Demographics
NPI:1609349570
Name:RUFFINO, BREANA (DPT)
Entity Type:Individual
Prefix:
First Name:BREANA
Middle Name:
Last Name:RUFFINO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16700 N THOMPSON PEAK PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2387
Mailing Address - Country:US
Mailing Address - Phone:480-629-4606
Mailing Address - Fax:480-629-8511
Practice Address - Street 1:16700 N THOMPSON PEAK PKWY STE 220
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2387
Practice Address - Country:US
Practice Address - Phone:480-629-4606
Practice Address - Fax:480-629-8511
Is Sole Proprietor?:No
Enumeration Date:2019-01-03
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ30345225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist