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1164545257
BENNIE SHAW
SACRAMENTO, CA
NPI
1164545257
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2007-04-06
Last Update Date
2007-07-08
Business Address
-- BENNIE SHAW
930 G STREET
SACRAMENTO, CA 95814
Phone number: 916-441-2933
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Mailing Address
-- BENNIE SHAW
3637 PULLMAN DRIVE
SACRAMENTO, CA 95827
Phone number: 916-441-2933
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