Individual
JERRY DON RUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
HEALTH TECH
Contact information
Practice address
3600 RIVERS AVE, NORTH CHARLESTON, SC 29405-7747
(843) 743-7868
Mailing address
3600 RIVERS AVE, NORTH CHARLESTON, SC 29405-7747
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
01/22/2010
Last updated
01/22/2010
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