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Individual

MR. DESTIN JOSEPH RADDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
L.AC.

Contact information

Practice address
627 CENTER ST, SANTA CRUZ, CA 95060-3804
(831) 426-5044
Mailing address
5320 MILITARY RD, SUITE 104, LEWISTON, NY 14092-2149
(716) 297-9379
(716) 297-4638

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
004488
NY
171100000X
Acupuncturist
12344
CA

Other

Enumeration date
10/03/2008
Last updated
11/11/2010
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