Individual
WADE THOMAS SKARDOUTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CP
Contact information
Practice address
3350 SCOTT BLVD STE 6301, 191 SAN FELIPE RD. STE M1 HOLLISTER, CA 95023, SANTA CLARA, CA 95054
(408) 845-9245
(408) 845-9259
Mailing address
3350 SCOTT BLVD STE 6301, SANTA CLARA, CA 95054-3125
(408) 845-9245
(408) 845-9259
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
CP003200
MI
Other
Enumeration date
01/24/2008
Last updated
06/17/2015
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