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1164129383
KEITH JIMMY POWELL
PASADENA, CA
NPI
1164129383
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2023-02-08
Last Update Date
2023-02-24
Business Address
KEITH JIMMY POWELL
691 E WASHINGTON BLVD
PASADENA, CA 91104-5003
Phone number: 626-698-9622
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Mailing Address
KEITH JIMMY POWELL
136 S VIRGIL AVE APT 109
LOS ANGELES, CA 90004-6039
Phone number:
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