Organization
MONICA RUDESTAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA RUDESTAM L.AC (SOLE PROPRIETOR)
(971) 409-4049
Entity
Organization
Contact information
Practice address
14936 3RD ST NE, AURORA, OR 97002-9221
(971) 409-4049
Mailing address
PO BOX 115, AURORA, OR 97002-0115
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
AC150554
OR
Other
Enumeration date
08/16/2011
Last updated
08/16/2011
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