Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 12773 | CA |
NPI | 1134519978 |
---|---|
Provider Name | Mr. David Woodruff Thomforde |
First Address | Whittier, CA 90605-2254 |
Second Address | Whittier, CA 90605-2254 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2015 |
Last Update Date | 02/02/2015 |