Individual
KIMBERLY RUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
710 S.E. GRAND DD TERRACE, FAUCETT, MO 64448
(314) 652-4100
Mailing address
710 S.E. GRAND DD TERRACE, FAUCETT, MO 64448
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
09/04/2019
Last updated
05/07/2020
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