Individual
MS. MERISA RUDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1108 EARL ST, PHILADELPHIA, PA 19125-4210
(267) 847-7150
Mailing address
1108 EARL ST, PHILADELPHIA, PA 19125-4210
(267) 847-7150
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
09/19/2014
Last updated
09/19/2014
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