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1023866282
JACK WADE
EL SEGUNDO, CA
NPI
1023866282
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2024-05-10
Last Update Date
2024-05-10
Business Address
JACK WADE
100 N PACIFIC COAST HWY
EL SEGUNDO, CA 90245-4359
Phone number: 424-210-9148
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Mailing Address
JACK WADE
100 N PACIFIC COAST HWY
EL SEGUNDO, CA 90245-4359
Phone number: 424-210-9148
Copy
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