Jack Rudolph

NPI 1487823308 · on the registry since 2008

Practice

Address: 540 College Ave
Medford, WI 54451
Phone: (715) 748-3332
Fax: (715) 748-3342
Organisation at this address: Taylor County
Taylor County
Taylor County
Taylor County
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 3

Registry record

Primary taxonomy: Counselor
101Y00000X
Licence states on file: WI
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2008-03-13

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin