Individual
ROUSLAN PETROVICH RECHETNIKOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2420 LAKE WHEELER RD, RALEIGH, NC 27603-2614
(419) 902-8326
Mailing address
123 HEDGEROW CT, CARY, NC 27513-4231
(419) 902-8326
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
7404
NC
Other
Enumeration date
04/23/2024
Last updated
04/23/2024
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