Individual
ZACHERY M. RUDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2909 MANNSVILLE RD, ELLIOTTSBURG, PA 17024-8923
(717) 636-9641
Mailing address
2909 MANNSVILLE RD, ELLIOTTSBURG, PA 17024-8923
(717) 636-9641
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
YWP80113775302
CAPITAL BLUE CROSS
PA
Enumeration date
03/07/2019
Last updated
03/07/2019
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