SHAD FOSSEN

LONG BEACH, CA
NPI1992823264
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225400000X Rehabilitation Practitioner
Enumeration Date2007-03-26
Last Update Date2013-05-24
Business Address
Mr. SHAD FOSSEN
456 ELM AVE
LONG BEACH, CA 90802-2426
Phone number: 562-437-6717
Mailing Address
Mr. SHAD FOSSEN
508 AGUA PL
SEAL BEACH, CA 90740-6216
Phone number:
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