Individual
KAYA KALEOLANI RUDDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MAS
Contact information
Practice address
770 CABINET GORGE RD, CLARK FORK, ID 83811-7002
(208) 304-2535
Mailing address
770 CABINET GORGE RD, CLARK FORK, ID 83811-7002
(208) 304-2535
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-3798
ID
Other
Enumeration date
11/18/2021
Last updated
11/18/2021
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