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1831692086
VIVIAN TANUDJAJA
LONG BEACH, CA
NPI
1831692086
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2018-03-14
Last Update Date
2018-03-14
Business Address
VIVIAN TANUDJAJA
6481 ATLANTIC AVE APT 135
LONG BEACH, CA 90805-2339
Phone number: 562-612-5696
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Mailing Address
VIVIAN TANUDJAJA
6481 ATLANTIC AVE APT 135
LONG BEACH, CA 90805-2339
Phone number: 562-612-5696
Copy
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