Healthcare Provider Details

I. General information

NPI: 1649189416
Provider Name (Legal Business Name): JENNIFER RUFFANER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2026
Last Update Date: 09/05/2026
Certification Date: 09/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 LIONS HILL RD
STATE COLLEGE PA
16803-1859
US

IV. Provider business mailing address

1310 RAILROAD ST
COALPORT PA
16627-9325
US

V. Phone/Fax

Practice location:
  • Phone: 814-235-8900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberTEI006734
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: