Provider Demographics
NPI:1841224813
Name:WURMSDOBLER, HARRY JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:JOSEPH
Last Name:WURMSDOBLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 E HUNTINGTON DR
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-3212
Mailing Address - Country:US
Mailing Address - Phone:626-445-0326
Mailing Address - Fax:626-445-5155
Practice Address - Street 1:131 E HUNTINGTON DR
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3212
Practice Address - Country:US
Practice Address - Phone:626-445-0326
Practice Address - Fax:626-445-5155
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC20045111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU07250Medicare UPIN