Individual
COLLEEN WENDTLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPED, CFOM
Taxonomy
Speciality
Code
Description
License number
State
224900000X
Mastectomy Fitter
—
—
224L00000X
Pedorthist
Primary
—
—
225000000X
Orthotic Fitter
—
—
Other
Enumeration date
05/25/2016
Last updated
05/25/2016
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