Most Relevant Information
Provider Data
| NPI Number: | 1003491127 |
| Provider Name: | EVELYN LUCILLE RUCKER |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/10/2021 |
| Last Updated: | 03/10/2021 |
Provider Practice Location
805 52ND ST NE
WASHINGTON
DC
200195512
Practice Location Phone/Fax
| Phone: | 2025252184 |
| Fax: |
Provider Mailing Location
805 52ND ST NE
WASHINGTON
DC
200195512
Provider Mailing Phone/Fax
| Phone: | 2025252184 |
| Fax: |