Provider Demographics
NPI:1154587350
Name:RUFO, JOHN A (PTA,ATC,)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:A
Last Name:RUFO
Suffix:
Gender:M
Credentials:PTA,ATC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 DOMINIC DR
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-3260
Mailing Address - Country:US
Mailing Address - Phone:603-866-4187
Mailing Address - Fax:
Practice Address - Street 1:172 LAWRENCE ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-3849
Practice Address - Country:US
Practice Address - Phone:978-685-6321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2469225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant