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Individual

BRYCE RUDEK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
591 PENDLETON ST, TAHLEQUAH, OK 74464-2271
(918) 458-4154
Mailing address
1390 N HERITAGE LN, APT 25, TAHLEQUAH, OK 74464-2136
(580) 512-5506

Taxonomy

Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
AT4225
TX

Other

Enumeration date
03/31/2016
Last updated
03/31/2016
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