Individual
RYAN JUDD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
AT00425
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2255A2300X
TECHNOLOGIST, ATHLETIC TRAINER
RI
Enumeration date
09/23/2015
Last updated
09/28/2016
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