Provider Demographics
NPI:1205570470
Name:CARRIE RUFFNER BODY BALANCE LLC
Entity type:Organization
Organization Name:CARRIE RUFFNER BODY BALANCE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:RUFFNER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:716-378-0689
Mailing Address - Street 1:4421 HAMMOCKS DR
Mailing Address - Street 2:
Mailing Address - City:GENESEO
Mailing Address - State:NY
Mailing Address - Zip Code:14454-9630
Mailing Address - Country:US
Mailing Address - Phone:716-378-0689
Mailing Address - Fax:
Practice Address - Street 1:5132 RTE 63
Practice Address - Street 2:
Practice Address - City:GENESEO
Practice Address - State:NY
Practice Address - Zip Code:14454-1445
Practice Address - Country:US
Practice Address - Phone:716-378-0689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-25
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy