Individual
MICHAEL RUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
544 UNION AVE, GRANTS PASS, OR 97527-5544
(541) 955-0940
Mailing address
544 UNION AVE, GRANTS PASS, OR 97527-5544
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
9986
OR
Other
Enumeration date
07/28/2021
Last updated
07/28/2021
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