Individual
KEVIN RUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9400 E 350, RAYTOWN, MO 64133-6509
(816) 358-5988
Mailing address
209 BLACKJACK AVE, LONE JACK, MO 64070-8151
(913) 709-2454
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2016024471
MO
Other
Enumeration date
11/27/2020
Last updated
11/27/2020
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