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Individual

WILLIAM R RUDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
2013 STATE ROUTE 59, KENT, OH 44240-4113
(330) 678-0201
(330) 678-4272
Mailing address
2013 STATE ROUTE 59, KENT, OH 44240-4113
(330) 678-0201
(330) 678-4272

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4310
OH
152W00000X
Optometrist
T305
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0239389
OH
Enumeration date
03/24/2006
Last updated
01/03/2014
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