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1730478066
MARK ANDREW TIEDEMAN
AGOURA HILLS, CA
NPI
1730478066
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: CA PT27038)
Enumeration Date
2011-04-07
Last Update Date
2011-04-07
Business Address
Mr. MARK ANDREW TIEDEMAN Physical Therapist
5927 KANAN RD
AGOURA HILLS, CA 91301-1688
Phone number: 818-889-0158
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Mailing Address
Mr. MARK ANDREW TIEDEMAN Physical Therapist
5927 KANAN RD
AGOURA HILLS, CA 91301-1688
Phone number: 818-889-0158
Copy
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