Provider Demographics
NPI:1811028335
Name:RUFF, KASEY MARIE (OTR, L)
Entity Type:Individual
Prefix:MRS
First Name:KASEY
Middle Name:MARIE
Last Name:RUFF
Suffix:
Gender:F
Credentials:OTR, L
Other - Prefix:MS
Other - First Name:KASEY
Other - Middle Name:MARIE
Other - Last Name:MESECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1115 9TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:IA
Mailing Address - Zip Code:50644-2717
Mailing Address - Country:US
Mailing Address - Phone:563-210-5009
Mailing Address - Fax:
Practice Address - Street 1:2300 SWAN LAKE BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:INDEPENDENCE
Practice Address - State:IA
Practice Address - Zip Code:50644-9707
Practice Address - Country:US
Practice Address - Phone:319-334-5155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01595225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist