Individual
RORY MACK RUSKOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
363A00000X
Physician Assistant
Primary
AMD-998
HI
Other
Enumeration date
06/23/2020
Last updated
06/27/2023
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