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Individual

DECKER WOOD SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
499 HUMBOLDT ST STE 104, SANTA ROSA, CA 95404-4214
(707) 565-7418
Mailing address
499 HUMBOLDT ST STE 104, SANTA ROSA, CA 95404-4214

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
365767
CA

Other

Enumeration date
01/23/2007
Last updated
08/25/2014
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