Individual
RICKEY CUZZORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
109 HOMESTEAD DR, ROUND ROCK, TX 78664-2396
(512) 689-1511
Mailing address
535 COUNTY ROAD 420, TAYLOR, TX 76574-3948
(512) 484-3474
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
160577
TX
Other
Enumeration date
08/02/2018
Last updated
08/02/2018
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