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Individual

MR. PAUL RUDD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
REG DIETICIAN

Contact information

Practice address
307 E 12TH ST, BENTON, KY 42025
(270) 527-1496
(270) 527-5321
Mailing address
267 SLICKBACK RD, BENTON, KY 42025-7629
(270) 527-1496
(270) 252-2737

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
KY1534
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
20079018
KY
Enumeration date
01/18/2007
Last updated
07/27/2016
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