Individual
REQUIEL RUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2146 N 11TH ST, MILWAUKEE, WI 53205-1313
(312) 287-2643
Mailing address
2146 N 11TH ST, MILWAUKEE, WI 53205-1313
(312) 287-2643
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
12/09/2024
Last updated
02/19/2025
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