Provider Demographics
NPI:1770131054
Name:RUDIO, CATHARINE AMANDA (LAT, ATC)
Entity type:Individual
Prefix:
First Name:CATHARINE
Middle Name:AMANDA
Last Name:RUDIO
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 W 3RD ST APT 1C
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1230
Mailing Address - Country:US
Mailing Address - Phone:862-268-2505
Mailing Address - Fax:
Practice Address - Street 1:641 TAYLOR ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-3107
Practice Address - Country:US
Practice Address - Phone:484-515-5696
Practice Address - Fax:610-758-6850
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-29
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0060052255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty