Individual
KATELYN MICHELLE RUDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
890 W MAIN ST STE 103, GENEVA, OH 44041-1237
(440) 466-4641
Mailing address
6230 MAXWELL DR, MADISON, OH 44057-2011
(910) 320-1406
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
50.009087RX
OH
Other
Enumeration date
10/08/2024
Last updated
10/08/2024
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