Most Relevant Information
Provider Data
| NPI Number: | 1003174806 |
| Provider Name: | ALICIA RUDDOCK ROURK RD, LDN |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 1259 |
Most Important Dates
| Enumeration Date: | 04/30/2012 |
| Last Updated: | 04/30/2012 |
Provider Practice Location
2390 W CONGRESS ST
LAFAYETTE
LA
705064205
Practice Location Phone/Fax
| Phone: | 3372616113 |
| Fax: | 3372616660 |
Provider Mailing Location
2390 W CONGRESS ST
LAFAYETTE
LA
705064205
Provider Mailing Phone/Fax
| Phone: | 3372616113 |
| Fax: | 3372616660 |