ANTONIO JERMAINE RUCKER

LONG BEACH, CA
NPI1134331200
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2007-05-03
Last Update Date2007-07-08
Business Address
-- ANTONIO JERMAINE RUCKER
40 ROSWELL AVE
LONG BEACH, CA 90803-2952
Phone number: 562-711-1147
Mailing Address
-- ANTONIO JERMAINE RUCKER
40 ROSWELL AVE
LONG BEACH, CA 90803-2952
Phone number:
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