Individual
DR. CLARK RUZICKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
610 FRONT ST, BX1420, LEADVILLE, CO 80461-1420
(719) 486-1175
Mailing address
PO BOX 1420, 610 FRONT ST, LEADVILLE, CO 80461-1420
Taxonomy
Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
Primary
2677
CO
Other
Enumeration date
06/29/2007
Last updated
07/08/2007
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