MICHAEL GENE RUCKER

TENINO, WA
NPI1578642914
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy224P00000X Prosthetist
(Licence: WA  PS00081)
Additional Taxonomies222Z00000X 
(Licence: WA  OI00082)
Enumeration Date2006-11-05
Last Update Date2007-12-17
Business Address
Mr. MICHAEL GENE RUCKER LPO
548 SUSSEX AVE W
TENINO, WA 98589-9341
Phone number: 360-264-6553
Mailing Address
Mr. MICHAEL GENE RUCKER LPO
225 143RD AVE SE
TENINO, WA 98589-9604
Phone number: 360-264-5342