Individual
BRIAN KIRK RUDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
5187 US ROUTE 60 STE 13, HUNTINGTON, WV 25705-2076
(304) 733-5010
Mailing address
5664 FISHER BOWEN BRANCH RD, WAYNE, WV 25570-5917
(304) 544-9930
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
110593
WV
Other
Enumeration date
09/14/2022
Last updated
09/14/2022
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