Individual
MRS. GAYLE L RUFFINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
1301 RUSSELL RD, RUSSELLVILLE, AR 72802-4320
(479) 967-2316
(479) 967-3639
Mailing address
PO DRAWER 2109, RUSSELLVILLE, AR 72811
(479) 967-2322
(479) 967-2876
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1107
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139751721
—
AR
01
—
5U925
BLUE CROSS ID NUMBER
AR
01
—
PT1107
STATE LICENSE NUMBER
AR
Enumeration date
04/10/2007
Last updated
01/13/2023
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