Individual
EDE J VOORHEIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2101 TENAYA DR, MODESTO, CA 95354-3930
(209) 576-6766
(209) 576-6770
Mailing address
1910 CUSTOMER CARE WAY, ATWATER, CA 95301-5167
(209) 384-6493
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA55140
CA
363AM0700X
Medical Physician Assistant
Primary
PA55140
CA
Other
Enumeration date
02/23/2018
Last updated
02/23/2018
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