Individual
BRANDON RUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
24451 LAKE SHORE BLVD APT 1817, EUCLID, OH 44123-1264
(614) 824-7590
Mailing address
24451 LAKE SHORE BLVD APT 1817, EUCLID, OH 44123-1264
(614) 824-7590
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN.156457-M-IV
OH
Other
Enumeration date
11/08/2014
Last updated
11/08/2014
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