Individual
LAUREN RUDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2555 E 13TH ST STE 105, LOVELAND, CO 80537-5134
(319) 384-7765
Mailing address
4832 MARIANA HILLS CIR, LOVELAND, CO 80537-7930
(720) 937-7954
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
DR.0062433
CO
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
R-11267
IA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/13/2014
Last updated
04/23/2020
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