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1104067743
GARY THERAGOOD
VICTORVILLE, CA
NPI
1104067743
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2009-03-11
Last Update Date
2018-09-18
Business Address
GARY THERAGOOD
15095 AMARGOSA RD STE 208
VICTORVILLE, CA 92394-1879
Phone number: 760-245-4695
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Mailing Address
GARY THERAGOOD
15095 AMARGOSA RD STE 201
VICTORVILLE, CA 92394-1868
Phone number:
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