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1114333796
MICHAEL MACK
BOULDER, CO
NPI
1114333796
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2014-07-03
Last Update Date
2014-07-03
Business Address
-- MICHAEL MACK
3450 BROADWAY ST
BOULDER, CO 80304-1824
Phone number: 303-441-1100
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Mailing Address
-- MICHAEL MACK
4347 E 135TH WAY
THORNTON, CO 80241-1583
Phone number:
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