Shane Richard Wurdeman CP

NPI 1497911572 - Prosthetist - 224P00000X

NPI Details
NPI 1497911572
Gender Male
Enumeration Date 07/29/2008
Last Updated 07/29/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
11301 WILSHIRE BLVD
BLDG 304
LOS ANGELES CA, 90073-1003, US
Phone (310) 478-3711
Fax
Business Location
1323 14TH ST
APT. E
SANTA MONICA CA, 90404-1744, US
Phone (310) 478-3711
Fax
Toxanomy
Taxonomy Code 224P00000X
License State California
License Number CP003610
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According to our database, Shane Richard Wurdeman CP NPI is 1497911572, taxonomy code is 224P00000X and license number is CP003610, license state is located at California. Shane Richard Wurdeman CP physically located at 11301 Wilshire Blvd, Los Angeles CA, 90073-1003. NPI Number Shane Richard Wurdeman CP has the Individual type.

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1497911572 NPI number is provided on an as is basis without warranty of any kind. 1497911572 is maintained by the National Plan & Provider Enumeration System. The contents of Shane Richard Wurdeman CP are for informational purposes only.