MICHAEL MACK

BOULDER, CO
NPI1114333796
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2014-07-03
Last Update Date2014-07-03
Business Address
-- MICHAEL MACK
3450 BROADWAY ST
BOULDER, CO 80304-1824
Phone number: 303-441-1100
Mailing Address
-- MICHAEL MACK
4347 E 135TH WAY
THORNTON, CO 80241-1583
Phone number: