Individual
MS. TAMMY RUST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2772 DWIGHT RD, SPRINGFIELD, OH 45503-5053
(260) 503-1151
Mailing address
2772 DWIGHT RD, SPRINGFIELD, OH 45503-5053
(260) 503-1151
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OTA 03539
OH
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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