Individual
SUSAN RUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
5 RUSSELL CT, NORTHPORT, NY 11768-3522
(631) 258-6612
(631) 757-0811
Mailing address
5 RUSSELL CT, NORTHPORT, NY 11768-3522
(631) 258-6612
(631) 757-0811
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
003115-1
NY
Other
Enumeration date
08/31/2010
Last updated
08/31/2010
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