Provider Demographics
NPI:1962202101
Name:RUFFALO, KATHRYNE ELIZABETH (DC)
Entity type:Individual
Prefix:
First Name:KATHRYNE
Middle Name:ELIZABETH
Last Name:RUFFALO
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DELAFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53018-1507
Mailing Address - Country:US
Mailing Address - Phone:262-232-7910
Mailing Address - Fax:262-232-7910
Practice Address - Street 1:711 MAIN ST
Practice Address - Street 2:
Practice Address - City:DELAFIELD
Practice Address - State:WI
Practice Address - Zip Code:53018-1507
Practice Address - Country:US
Practice Address - Phone:262-232-7910
Practice Address - Fax:262-232-7910
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6291-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor