Organization
SCATTER CREEK PROSTHETICS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL GENE RUCKER LPO (PRESIDENT)
(360) 264-6553
Entity
Organization
Contact information
Practice address
548 SUSSEX AVE W, TENINO, WA 98589-9341
(360) 264-6553
Mailing address
225 143RD AVE SE, TENINO, WA 98589-9604
(360) 264-6553
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
—
—
224P00000X
Prosthetist
Primary
—
—
Other
Enumeration date
12/26/2006
Last updated
02/04/2008
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