Provider Demographics
NPI:1760683767
Name:RAUGH, JOHN RANDOLPH (PT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:RANDOLPH
Last Name:RAUGH
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 1:8600 E ROCKCLIFF RD
Mailing Address - Street 2:LIFE ENHANCEMENT CENTER
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-9733
Mailing Address - Country:US
Mailing Address - Phone:520-749-9600
Mailing Address - Fax:520-239-8560
Practice Address - Street 1:8600 E ROCKCLIFF RD
Practice Address - Street 2:CANYON RANCH HEALTH RESORT - LEC
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85750-9733
Practice Address - Country:US
Practice Address - Phone:520-749-9655
Practice Address - Fax:520-239-8560
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist