KEITH GERARD DAVIS

LOS ANGELES, CA
NPI1104169127
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2013-03-27
Last Update Date2013-03-27
Business Address
Mr. KEITH GERARD DAVIS
4715 CRENSHAW BLVD
LOS ANGELES, CA 90043-1233
Phone number: 323-988-3744
Mailing Address
Mr. KEITH GERARD DAVIS
4715 CRENSHAW BLVD
LOS ANGELES, CA 90043-1233
Phone number: 323-988-3744