Individual
KALLEN RUDDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
377 GILMORE ST # B, MORGANTOWN, WV 26505-4654
(480) 415-8448
Mailing address
377 GILMORE ST # B, MORGANTOWN, WV 26505-4654
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/09/2026
Last updated
01/09/2026
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