Healthcare Provider Details

I. General information

NPI: 1568374213
Provider Name (Legal Business Name): KARLIE ANN RUDNIK PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 W 13TH ST
GRAFTON ND
58237-1826
US

IV. Provider business mailing address

164 W 13TH ST
GRAFTON ND
58237-1826
US

V. Phone/Fax

Practice location:
  • Phone: 701-352-1620
  • Fax:
Mailing address:
  • Phone: 701-352-9398
  • Fax: 701-352-9382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2870
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: