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1083064562
JERRY MARTIN
FRESNO, CA
NPI
1083064562
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 20098N)
Enumeration Date
2016-06-15
Last Update Date
2016-06-16
Business Address
-- JERRY MARTIN
4411 N CEDAR AVE STE 108
FRESNO, CA 93726-2538
Phone number: 559-248-1548
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Mailing Address
-- JERRY MARTIN
4411 N CEDAR AVE STE 108
FRESNO, CA 93726-2538
Phone number: 559-248-1548
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