NPI 1013072669

Kevin Patrick Ruddell, DC

Practitioner Chiropractor Lewiston, ID

Practice location

Address: 1117 16th Avenue, Lewiston, ID 83501
Phone: (208) 743-8401
Fax: (208) 743-8722

Registered specialties

Chiropractor Primary

Chiropractic Providers Taxonomy 111N00000X Licence CHIR 725 (ID)

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Registry record

NPI: 1013072669
Entity type: Individual
Sex (as registered): Male
NPI issued: 26 Dec 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.