Jordan Taylor Rucks

NPI #1255932539 in Centereach, New York

Provider Information

NPI Number: 1255932539
Entity Type: Individual
Name: Jordan Taylor Rucks
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Nov 4, 2020
Last Updated: Nov 4, 2020

Practice Location

Address: 17 HOLLINGSWORTH PL
City: Centereach
State: New York
ZIP Code: 11720-2111
Phone: (772) 214-5356

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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