Individual
DR. PHILLIP D. RUPPERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1438 S GRAND BLVD, SAINT LOUIS, MO 63104-1027
(314) 577-8000
Mailing address
1 OAK DR UNIT 352, MARYVILLE, IL 62062-7026
(618) 391-4021
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
071009269
IL
103G00000X
Clinical Neuropsychologist
Primary
2014031617
MO
Other
Enumeration date
08/16/2011
Last updated
02/10/2022
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