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1497911572
SHANE RICHARD WURDEMAN
LOS ANGELES, CA
NPI
1497911572
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
224P00000X Prosthetist
(Licence: CA CP003610)
Enumeration Date
2008-07-29
Last Update Date
2008-07-29
Business Address
-- SHANE RICHARD WURDEMAN CP
11301 WILSHIRE BLVD BLDG 304
LOS ANGELES, CA 90073-1003
Phone number: 310-478-3711
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Mailing Address
-- SHANE RICHARD WURDEMAN CP
1323 14TH ST APT. E
SANTA MONICA, CA 90404-1744
Phone number: 310-478-3711
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