Individual
THOMAS JAMES WIEDEMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPH, MTS
Contact information
Practice address
11201 BENTON ST, LOMA LINDA, CA 92357-1000
(843) 789-7718
Mailing address
11201 BENTON ST, LOMA LINDA, CA 92357-1000
(843) 789-7718
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
02/10/2020
Last updated
09/12/2022
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