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1134267388
JOHN BRIAN VANDYCK
SAN ANDREAS, CA
NPI
1134267388
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-02-01
Last Update Date
2007-07-08
Business Address
Mr. JOHN BRIAN VANDYCK Rev.
891 MOUNTAIN RANCH RD
SAN ANDREAS, CA 95249-9713
Phone number: 209-754-6555
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Mailing Address
Mr. JOHN BRIAN VANDYCK Rev.
PO BOX 56
TWAIN HARTE, CA 95383-0056
Phone number: 209-754-2805
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