Individual
ALLEN EDWARD RUDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1839 E CAPITOL AVE STE B, BISMARCK, ND 58501
(701) 369-3938
Mailing address
1839 E CAPITOL AVE STE B, BISMARCK, ND 58501-5617
(507) 380-6812
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
4016
MN
111N00000X
Chiropractor
Primary
887
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17325
—
ND
01
—
887
STATE LICENSE
ND
Enumeration date
03/26/2007
Last updated
05/25/2018
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