Ruddell, Kevin Patrick

Ruddell, Kevin Patrick is an individual health care provider with primary practice located at 1117 16Th Avenue , Lewiston ID 83501. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Ruddell, Kevin Patrick can be contacted via phone (208) 743-8401.

Contact Information

Primary practice address
1117 16Th Avenue Lewiston ID 83501
Phone: (208) 743-8401
Fax: (208) 743-8722
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X CHIR 725 Idaho

Profile Details

NPI number 1013072669
LBN Legal business name Ruddell, Kevin Patrick
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 26th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013072669 NPPES
Idaho Other 000010024191 REGENCE
Idaho Other 0190459 REGENCE
Idaho Other C7259 REGENCE

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