Individual
CHARLES RUDOLPH III
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
8600 WARD PKWY, #710, KANSAS CITY, MO 64114-2614
(816) 523-8886
(816) 523-1810
Mailing address
11103 WEST AVE, SAN ANTONIO, TX 78213-1370
(210) 524-6663
(210) 524-6587
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2005020473
MO
Other
Enumeration date
05/08/2006
Last updated
07/08/2007
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