Individual
MR. RUDOLPH RICHARD WENCL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
600 S 21ST ST, COLORADO SPRINGS, CO 80904-3762
(719) 522-1133
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 579-3203
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0001485
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000204150
—
CO
Enumeration date
12/08/2006
Last updated
04/17/2026
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