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1184854788
IDA PHAE MACK
NORTH HILLS, CA
NPI
1184854788
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225400000X Rehabilitation Practitioner
Enumeration Date
2009-07-17
Last Update Date
2009-07-29
Business Address
Ms. IDA PHAE MACK BA
15317 RAYEN ST
NORTH HILLS, CA 91343-5117
Phone number: 818-892-3423
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Mailing Address
Ms. IDA PHAE MACK BA
15317 RAYEN ST
NORTH HILLS, CA 91343-5117
Phone number: 818-892-3423
Copy
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