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Individual

NICOLE RUDOLPH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
301 RICE MEADOW WAY, 3, COLUMBIA, SC 29229-8403
(803) 369-1203
Mailing address
7648 GARNERS FERRY RD, 148, COLUMBIA, SC 29209-3867

Taxonomy

Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary

Other

Enumeration date
05/03/2013
Last updated
05/03/2013
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