Individual
ALEX VONDACHENHAUSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
320 HARTNELL AVE, REDDING, CA 96002-1846
(530) 226-9242
(530) 226-9070
Mailing address
2520 GOODWATER AVE, SUITE A, REDDING, CA 96002-1514
(530) 224-3322
(530) 224-3325
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT11358
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ23129Z
MEDICARE GROUP
—
Enumeration date
07/19/2006
Last updated
09/20/2007
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