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OLON WAFER

>> Case Manager/Care Coordinator >> Other Service Providers

Registrant NPI Number: 1265892806

Individual Registrant:
 OLON  WAFER 
Gender: M
Not Sole Proprietor

Location and contact information for practice:
1600 BAILEY AVE STE 2  NEEDLES, CA 92363-3105 US
Tel: 760-326-9313  Fax: --

Contact information for business:
2158 SUTTER WAY APT 202  BULLHEAD CITY, AZ 86442-9536 US
Tel: 928-293-1773  Fax: --

Registration Information:
NPI: 1265892806
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y171M00000XOther Service Providers
Case Manager/Care Coordinator

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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