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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

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