PETER THEODORUS OTTO VAN DER HEIDE

ENCINO, CA
NPI1043670227
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: CA  291180)
Enumeration Date2016-03-01
Last Update Date2016-03-01
Business Address
-- PETER THEODORUS OTTO VAN DER HEIDE DPT
5500 LINDLEY AVE UNIT 121
ENCINO, CA 91316-1904
Phone number: 408-398-1163
Mailing Address
-- PETER THEODORUS OTTO VAN DER HEIDE DPT
5500 LINDLEY AVE UNIT 121
ENCINO, CA 91316-1904
Phone number: 408-398-1163
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