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General NPI Number Information
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NPI Number | 1467404442
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Entity Type | Organization
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Legal Business Name | LES D RUSKIN DC PA
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 01/24/2018
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Provider Practice Location Address
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Address Line | 3488 E LAKE RD STE 102B
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City | PALM HARBOR
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State | FL
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Zip | 34685-2404
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Country | US
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Telephone | 727-785-2545
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Fax | 727-781-0617
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Provider Business Mailing Address
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Address Line | 3488 E LAKE RD STE 102B
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City | PALM HARBOR
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State | FL
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Zip | 34685-2404
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Country | US
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Telephone | 727-785-2545
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Fax | 727-781-0617
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Authorized Official
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Title or Position | PRESIDENT DIRECTOR
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Name | DR. LES D RUSKIN
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Credential | DC
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Telephone | 727-785-2545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH0005390
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License Number State | FL
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