Individual
WENDEMAGEN THEODORE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2821 S PARKER RD STE 2-1017, AURORA, CO 80014-2735
(616) 644-8235
Mailing address
2821 S PARKER RD STE 2-1017, AURORA, CO 80014-2735
(616) 644-8235
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
04UCCC
CO
Other
Enumeration date
10/07/2024
Last updated
10/09/2024
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