Individual
JANICE DECORDOVA RUDEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6843 MAIN ST, BONNERS FERRY, ID 83805-8552
(208) 290-7281
(866) 801-7696
Mailing address
PO BOX 1446, BONNERS FERRY, ID 83805-1446
(208) 290-7281
(866) 801-7696
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MASG17
ID
Other
Enumeration date
09/18/2019
Last updated
01/05/2023
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