Individual
ERICH RUDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
356 NE BEACON DR, GRANTS PASS, OR 97526-3815
(541) 474-1033
Mailing address
PO BOX 1121, ROSEBURG, OR 97470-0254
(541) 672-2691
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/04/2025
Last updated
03/04/2025
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