Individual
RACHEL MARIE RUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
1241 W. STADIUM BLVD., JEFFERSON CITY, MO 65109-6023
(573) 635-5264
(573) 634-7423
Mailing address
P.O. BOX 104240, JEFFERSON CITY, MO 65110-4240
(573) 635-5264
(573) 636-9756
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
188.000680
IL
207Q00000X
Family Medicine Physician
Primary
2017022857
MO
207Q00000X
Family Medicine Physician
R-10699
IA
Other
Enumeration date
06/29/2016
Last updated
06/28/2023
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