Individual
JEDEDIAH CHESTON RUDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S., O.T.R/L
Contact information
Practice address
4134 N BLACKHAWK RD, SILVER CITY, NM 88061-6037
(575) 574-8212
Mailing address
4134 N BLACKHAWK RD, SILVER CITY, NM 88061-6037
(575) 574-8212
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2626
NM
Other
Enumeration date
08/09/2010
Last updated
08/16/2010
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