Organization
THE JODY HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RUTH LEE RUCK (ADMINISTRATOR)
(573) 578-2979
Entity
Organization
Contact information
Practice address
603 N WALNUT ST, ROLLA, MO 65401-3356
(573) 364-1589
Mailing address
407 E 6TH ST, ROLLA, MO 65401-3368
(573) 578-2979
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
MO
Other
Enumeration date
02/17/2007
Last updated
08/22/2020
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