Individual
SHANE RUCKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4403 HARRISON BLVD STE 3490, OGDEN, UT 84403-3284
(801) 387-2650
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
10498620-1205
UT
Other
Enumeration date
04/11/2016
Last updated
11/07/2023
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