Healthcare Provider Details

I. General information

NPI: 1578596367
Provider Name (Legal Business Name): PAULA LYNN RUFFIN DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 08/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30033 SHEFPO
NEW HUDSON MI
48165
US

IV. Provider business mailing address

30033 SHEFPO PO BOX 315
NEW HUDSON MI
48165
US

V. Phone/Fax

Practice location:
  • Phone: 248-486-5684
  • Fax: 248-486-5686
Mailing address:
  • Phone: 248-486-5684
  • Fax: 248-486-5686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberPR007680
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: