Healthcare Provider Details

I. General information

NPI: 1275339921
Provider Name (Legal Business Name): BRITTANY RUGG PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2025
Last Update Date: 02/24/2025
Certification Date: 02/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12120 COUNTY ROAD 103
OXFORD FL
34484-2987
US

IV. Provider business mailing address

PO BOX 61
OXFORD FL
34484-0061
US

V. Phone/Fax

Practice location:
  • Phone: 352-571-5554
  • Fax:
Mailing address:
  • Phone: 352-571-5554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA31824
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: