Individual
RUSTY LEE SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1700 E 38TH ST, MARION, IN 46953-4568
(765) 674-3321
(765) 677-6175
Mailing address
1700 E 38TH ST, MARION, IN 46953-4568
(765) 674-3321
(765) 677-6175
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
30003883A
IN
Other
Enumeration date
02/09/2022
Last updated
02/09/2022
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