Individual
KATRELL RUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5 CEDAR RUN LN APT 7, LAKE ST LOUIS, MO 63367-2707
(636) 466-7745
Mailing address
5 CEDAR RUN LN APT 7, LAKE ST LOUIS, MO 63367-2707
Taxonomy
Speciality
Code
Description
License number
State
343800000X
Secured Medical Transport (VAN)
Primary
—
MO
Other
Enumeration date
04/20/2022
Last updated
04/20/2022
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