Individual
JUDSON STURDIVANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1101 BUNTON CREEK ROAD, KYLE, TX 78640
(512) 699-3744
Mailing address
1101 BUNTON CREEK, KYLE, TX 78640
(512) 699-3744
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
08/13/2019
Last updated
08/13/2019
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