Individual
JOHN WIDENMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CTRS
Contact information
Practice address
150 MUIR RD, MARTINEZ, CA 94553-4668
(925) 372-2232
Mailing address
150 MUIR RD, MARTINEZ, CA 94553-4668
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
62583
—
Other
Enumeration date
05/20/2020
Last updated
05/20/2020
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