Individual
MR. BRYAN RUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2321 HIGHWAY 80 E, MONROE, LA 71203-9366
(318) 600-3333
Mailing address
2321 HIGHWAY 80 E, MONROE, LA 71203-9366
(318) 600-3333
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4131
LA
Other
Enumeration date
02/12/2020
Last updated
02/12/2020
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