Individual
RICKI TUFFENTSAMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
406 RADISSON RD, MARQUETTE HEIGHTS, IL 61554-1454
(309) 472-6541
Mailing address
406 RADISSON RD, MARQUETTE HEIGHTS, IL 61554-1454
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160005048
IL
225200000X
Physical Therapy Assistant
2100573
TX
225200000X
Physical Therapy Assistant
A-1344
NM
Other
Enumeration date
08/24/2017
Last updated
08/24/2017
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