Provider Demographics
NPI:1962978767
Name:RUFF, KAYLA ANNE (PTA)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:ANNE
Last Name:RUFF
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:
Other - Last Name:SCHILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2541 IRONWOOD DR APT 402
Mailing Address - Street 2:
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53590-8829
Mailing Address - Country:US
Mailing Address - Phone:715-933-1753
Mailing Address - Fax:
Practice Address - Street 1:198 COUNTY ROAD DF
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:WI
Practice Address - Zip Code:53039-9515
Practice Address - Country:US
Practice Address - Phone:920-386-3461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-18
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2759-19225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant