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1215391875
SHANE RUCKEL
OGDEN, UT
NPI
1215391875
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207RC0000X Internal Medicine Cardiovascular Disease
(Licence: UT 10498620-1205)
Enumeration Date
2016-04-11
Last Update Date
2023-11-07
Business Address
SHANE RUCKEL
4403 HARRISON BLVD STE 3490
OGDEN, UT 84403-3284
Phone number: 801-387-2650
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Mailing Address
SHANE RUCKEL
PO BOX 27128
SALT LAKE CITY, UT 84127-0128
Phone number:
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