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Mr. Ciro J Rustici
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NPI Number Detailed Information
Provider Information:
| Name: | Mr. Ciro J Rustici |
| Gender: | M |
| Provider License Number If Given: | 3592 |
NPI Information:
| NPI: | 1992704423 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 7/18/2005 |
| Last Update Date: | 8/2/2007 |
Provider Business Mailing Address:
| Address: | 17000 E 40 HWY SUITE 7 Independence, MO 64055 |
| Phone Number: | 8163736363 |
| Fax Number: | 8163736386 |
Provider Business Practice Location Address:
| Address: | 17000 E 40 HWY SUITE 7 Independence, MO 64055 |
| Phone Number: | 8163736363 |
| Fax Number: | 8163736386 |
Provider Taxonomy:
| Primary: | 111N00000X |
| Secondary (if any): | |
| State: | MO |
