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1275065674
BRIAN RIDDERUS OUDYK
LAS VEGAS, NV
NPI
1275065674
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: NV 0506201)
Enumeration Date
2017-04-03
Last Update Date
2017-04-03
Business Address
Mr. BRIAN RIDDERUS OUDYK ATC, LAT, CAT(C)
980 KELLY JOHNSON DR STE 200
LAS VEGAS, NV 89119-3768
Phone number: 702-352-0200
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Mailing Address
Mr. BRIAN RIDDERUS OUDYK ATC, LAT, CAT(C)
216 SUMMER PALACE WAY
LAS VEGAS, NV 89144-4116
Phone number: 702-265-6058
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