Individual
BRIAN ANDREW RUDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
611 PLEASANT GROVE RD, PLEASANT GROVE, AL 35127-2801
(205) 744-9401
Mailing address
611 PLEASANT GROVE RD, PO BOX 399, PLEASANT GROVE, AL 35127-2801
(205) 744-9401
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13708
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13708
STATE LICENSE
AL
01
—
25614
STATE LICENSE
TN
Enumeration date
01/19/2007
Last updated
07/08/2007
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