Organization
LAURIE M. WOLL D.O.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON A SEHNE (BUSINESS MANAGER)
(909) 625-5567
Entity
Organization
Contact information
Practice address
9301 CENTRAL AVE STE 201, MONTCLAIR, CA 91763-2446
(909) 625-5567
(909) 621-4900
Mailing address
9301 CENTRAL AVE., SUITE 201, MONTCLAIR, CA 91763
(909) 625-5567
(909) 621-4900
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA17704
CA
Other
Enumeration date
04/22/2011
Last updated
04/22/2011
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