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1114047545
JOHN WALKER
COMMACK, NY
NPI
1114047545
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NY 12833)
Enumeration Date
2007-03-30
Last Update Date
2007-07-08
Business Address
-- JOHN WALKER ASAC
155 INDIAN HEAD RD
COMMACK, NY 11725-2212
Phone number: 631-543-6200
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Mailing Address
-- JOHN WALKER ASAC
33 E BEECH ST
CENTRAL ISLIP, NY 11722-3140
Phone number: 631-543-6200
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