Individual
JOHN WIEDERANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1475 N GRANITE REEF RD, SCOTTSDALE, AZ 85257-3919
(480) 990-1904
Mailing address
1475 N GRANITE REEF RD, SCOTTSDALE, AZ 85257-3919
(480) 990-1904
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5271
AZ
Other
Enumeration date
10/30/2012
Last updated
10/30/2012
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