Individual
SUZANNE ELIZABETH RUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
9471 THREE RIVERS RD, STE D, GULFPORT, MS 39503-4230
(228) 822-9066
(228) 822-9722
Mailing address
1220 JOHN EVANS DR, GULFPORT, MS 39507-3638
(228) 326-7006
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT3556
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04178840
—
MS
Enumeration date
08/24/2006
Last updated
07/08/2007
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