Individual
DR. SHAWN A RUDKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC CCEP
Contact information
Practice address
101 E GROVE AVENUE, PARMA, ID 83660-0154
(208) 722-9999
Mailing address
PO BOX 154, PARMA, ID 83660-0154
(208) 722-9999
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA857
ID
Other
Enumeration date
11/22/2006
Last updated
05/13/2008
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