NICHOLAS DEWAYNE RUCKER

LITTLE ROCK, AR
NPI1700046059
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2008-06-11
Last Update Date2008-06-11
Business Address
Mr. NICHOLAS DEWAYNE RUCKER
6425 W 12TH ST
LITTLE ROCK, AR 72204-1509
Phone number: 501-666-7233
Mailing Address
Mr. NICHOLAS DEWAYNE RUCKER
PO BOX 251970
LITTLE ROCK, AR 72225-1970
Phone number: 501-660-6886
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