Individual
JOHN STEPHEN RUDDEROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3 RIVERSIDE CIR, ROANOKE, VA 24016
(972) 978-8758
Mailing address
319 N GLADSTONE BLVD, KANSAS CITY, MO 64123-1208
(972) 978-8758
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0102205193
VA
Other
Enumeration date
04/02/2012
Last updated
12/08/2020
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