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1225500010
MICHAEL D FORKS
ANTIOCH, CA
NPI
1225500010
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2018-12-18
Last Update Date
2018-12-18
Business Address
MICHAEL D FORKS
4849 LONE TREE WAY
ANTIOCH, CA 94531-8644
Phone number: 925-462-2281
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Mailing Address
MICHAEL D FORKS
5064 TEHACHAPI WAY
ANTIOCH, CA 94531-8807
Phone number: 415-774-6349
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