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Individual

HOLLY RUDD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1841 E MAIN ST, BARSTOW, CA 92311-3234
(760) 255-5704
Mailing address
1841 E MAIN ST, BARSTOW, CA 92311-3234
(760) 255-5704

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary

Other

Enumeration date
09/12/2019
Last updated
09/12/2019
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