Provider Demographics
NPI:1952600017
Name:RUFF, SARAH JANE (PT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JANE
Last Name:RUFF
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:679 E 900 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:GRIDLEY
Mailing Address - State:IL
Mailing Address - Zip Code:61744-4034
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:679 E 900 NORTH RD
Practice Address - Street 2:
Practice Address - City:GRIDLEY
Practice Address - State:IL
Practice Address - Zip Code:61744-4034
Practice Address - Country:US
Practice Address - Phone:309-261-3416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-15
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1193108225100000X
IN05010521A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist