Provider Demographics
NPI:1740492636
Name:RUFF, KENNETH JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:JAMES
Last Name:RUFF
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1940
Mailing Address - Street 2:
Mailing Address - City:BOYES HOT SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:95416-1940
Mailing Address - Country:US
Mailing Address - Phone:707-996-7833
Mailing Address - Fax:707-935-6539
Practice Address - Street 1:19016 BAY ST.
Practice Address - Street 2:
Practice Address - City:EL VERANO
Practice Address - State:CA
Practice Address - Zip Code:95433
Practice Address - Country:US
Practice Address - Phone:707-996-7833
Practice Address - Fax:707-935-6539
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0133790111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC-0133790OtherCHIROPRACTIC LICENSE