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Individual

MR. LAYNE SEICHI WAKUTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1670 W 162ND ST, GARDENA, CA 90247-3734
(310) 483-8198
Mailing address
1670 W. 162ND ST, GARDENA, CA 90247
(310) 217-9537

Taxonomy

Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
CA

Other

Enumeration date
02/27/2019
Last updated
07/15/2020
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