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Individual

RUSTICO PAULINO LEGASPI JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
6505 BILLINGS LAKE DR, COLUMBUS, GA 31909-4447
(615) 397-8840
Mailing address
6505 BILLINGS LAKE DR, COLUMBUS, GA 31909-4447

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
300852
GA
163WP0808X
Psychiatric/Mental Health Registered Nurse
762375
NY

Other

Enumeration date
07/08/2025
Last updated
07/08/2025
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