Individual
STACEY LYNN RUDDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 MAYER RD, FRANKENMUTH, MI 48734-1334
(989) 652-4663
Mailing address
4300 CHESANING RD, CHESANING, MI 48616-8422
(989) 245-0870
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502000759
MI
Other
Enumeration date
04/29/2020
Last updated
04/29/2020
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