Individual
MR. ADRIANUS MATHIAS VANDERWERFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
469 E NORTH ST, MANTECA, CA 95336-4710
(916) 996-8459
Mailing address
657 BODESON CT, RIPON, CA 95366-9596
(916) 996-8459
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT 6812
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT 6812
PHYSICAL THERAPIST ASSISTANT
CA
Enumeration date
11/29/2012
Last updated
11/29/2012
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