Provider Demographics
NPI:1831226554
Name:RUFF, SHAWN ALLEN (MS ATC)
Entity type:Individual
Prefix:MR
First Name:SHAWN
Middle Name:ALLEN
Last Name:RUFF
Suffix:
Gender:M
Credentials:MS ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3109 6TH AVE N
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59401-2113
Mailing Address - Country:US
Mailing Address - Phone:406-268-1962
Mailing Address - Fax:
Practice Address - Street 1:3109 6TH AVE N
Practice Address - Street 2:1900 2ND AVE SOUTH
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-2113
Practice Address - Country:US
Practice Address - Phone:406-268-1962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer