Organization
AXIS INTEGRATIVE MEDICAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILDER RUCKER MD (OWNER)
(914) 747-9200
Entity
Organization
Contact information
Practice address
879 COMMERCE ST, THORNWOOD, NY 10594-1415
(914) 747-9200
(914) 747-4406
Mailing address
879 COMMERCE ST, THORNWOOD, NY 10594-1415
(914) 747-9200
(914) 747-4406
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
264414
NY
Other
Enumeration date
05/08/2013
Last updated
05/08/2013
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