Individual
MR. KEVIN WAYNE RUSCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
5475 N CATTLEMEN DR, PRESCOTT VALLEY, AZ 86314-4312
(928) 301-4309
Mailing address
5475 N CATTLEMEN DR, PRESCOTT VALLEY, AZ 86314-4312
(928) 301-4309
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT22788
AZ
Other
Enumeration date
03/07/2020
Last updated
03/07/2020
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