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Contact Information

KEVIN P RUDDELL, DC
1117 16TH AVENUE
LEWISTON, ID83501
 Phone: 208-743-8401
 Fax: 208-743-8722
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Chiropractor

111N00000X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for KEVIN P RUDDELL · (Male)

NPI Number 1013072669
Status Active
Credentials DC (Doctor of Chiropractic)
Entity Individual
Enumeration date 12/26/2006
Last updated 07/08/2007 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • ID License # CHIR 725
  • Other 0190459 DEPT LABOR & INDUSTRIES
  • ID Other C7259 BLUE CROSS
  • ID Other 000010024191 REGENCE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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