Organization
LAURIE M. WOLL, D.O., DERMATOLOGY, A MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURIE M WOLL D.O. (PRESIDENT/OWNER)
(909) 621-5005
Entity
Organization
Contact information
Practice address
9301 CENTRAL AVE, MONTCLAIR, CA 91763-2420
(909) 621-5005
(909) 621-4900
Mailing address
9301 CENTRAL AVE, MONTCLAIR, CA 91763-2420
(909) 621-5005
(909) 621-4900
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
20A4394
CA
Other
Enumeration date
10/02/2007
Last updated
11/17/2010
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