Individual
KELLY DONN RUDD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
500 N SUPERIOR AVE, TOMAH, WI 54660-1114
(608) 372-3348
(608) 372-5693
Mailing address
500 N SUPERIOR AVE, PO BOX 937, TOMAH, WI 54660-1114
(608) 372-3348
(608) 372-5693
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1712
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38775000
—
WI
Enumeration date
11/28/2006
Last updated
07/08/2007
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