Individual
JAYVANA RUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
755 N SALINA ST, SYRACUSE, NY 13208-2510
(315) 455-9090
Mailing address
755 N SALINA ST, SYRACUSE, NY 13208-2510
(315) 455-9090
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
224P00000X
Prosthetist
—
—
Other
Enumeration date
08/22/2023
Last updated
08/22/2023
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