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Individual

SCULLA O. CONRAD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
C PED

Contact information

Practice address
1553 S NOVATO BLVD STE D, NOVATO, CA 94947-4112
(415) 892-5788
(415) 898-0852
Mailing address
1553 S NOVATO BLVD STE D, NOVATO, CA 94947-4112
(415) 892-5788
(415) 898-0852

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
2196
CA

Other

Enumeration date
03/01/2007
Last updated
01/08/2009
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