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Dr. Thane Castulo Wedum, DPM
Student in an Organized Health Care Education/Training Program in Johnson City, Tennessee
NPI 1770293326

Thane Castulo Wedum is a Student in an Organized Health Care Education/Training Program based in Johnson City, TN. Thane Castulo Wedum practices in Johnson City, TN and has the professional credentials of DPM. The NPI Number for Thane Castulo Wedum is 1770293326 and holds a License No. (Tennessee).

The current practice location address for Thane Castulo Wedum is 809 Lamont St, Johnson City, TN and can be reached out via phone at 423-926-1171.

Location: 809 Lamont St, Johnson City, TN, 37615-5026
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1770293326
Provider Name
Thane Castulo Wedum
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
809 Lamont St, Johnson City, TN, 37615-5026
Phone Number
423-926-1171
Fax Number
Provider Enumeration Date
12/05/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
809 Lamont St
City
Johnson City
State
Tennessee
Zip
37604-5453
Phone Number
423-926-1171
Fax Number
person
Provider Business Mailing Address Details
Address
809 Lamont St
City
Johnson City
State
Tennessee
Zip
37604-5453
Phone Number
423-926-1171
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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