Individual
DEREK RUDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CMT
Contact information
Practice address
1999 S MAIN ST, STE 303 B, BLACKSBURG, VA 24060-6634
(540) 798-7525
Mailing address
1999 S MAIN ST, STE 303 B, BLACKSBURG, VA 24060-6634
(540) 798-7525
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0019013520
VA
Other
Enumeration date
06/17/2016
Last updated
06/17/2016
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