Individual
MS. GLENDA FAYE RUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14309 ROCKDALE ST, DETROIT, MI 48223-2518
(313) 534-1495
Mailing address
14309 ROCKDALE ST, DETROIT, MI 48223-2518
(313) 534-1495
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
MI
247200000X
Other Technician
—
—
Other
Enumeration date
06/24/2016
Last updated
07/11/2016
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