Individual
MICHAEL RUDDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
HWY 160 1/2 MILE SOUTH OF MILE POST 394.3, KAYENTA, AZ 86033
(928) 697-4165
Mailing address
PO BOX 368, KAYENTA, AZ 86033-0368
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RI01892200
NJ
Other
Enumeration date
02/14/2018
Last updated
02/14/2018
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