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Individual

PETR RUDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APRN

Contact information

Practice address
275 W 200 N, LINDON, UT 84042-5009
(801) 796-1333
(801) 756-1705
Mailing address
275 W 200 N, LINDON, UT 84042-5009
(801) 796-1333
(801) 756-1705

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
7505511-4405
UT

Other

Enumeration date
08/31/2015
Last updated
08/31/2015
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