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Individual

RYAN JUDD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
27 GOLDEN DR, EASTHAMPTON, MA 01027-2565
(413) 320-8429
Mailing address
27 GOLDEN DR, EASTHAMPTON, MA 01027-2565
(413) 320-8429

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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