Individual
NOAH WILLIAM VUTHEIKUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
9620 FREMONT AVE, MONTCLAIR, CA 91763-2320
(909) 621-4751
Mailing address
10434 VIA PALMA, MONTCLAIR, CA 91763-4751
(626) 233-8052
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
510126
CA
Other
Enumeration date
08/21/2024
Last updated
08/21/2024
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