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1225773419
JACK THORSON MOLL
LOS ANGELES, CA
NPI
1225773419
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2022-05-02
Last Update Date
2022-05-02
Business Address
Mr. JACK THORSON MOLL
8831 VENICE BLVD
LOS ANGELES, CA 90034-3223
Phone number: 310-204-5200
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Mailing Address
Mr. JACK THORSON MOLL
8831 VENICE BLVD
LOS ANGELES, CA 90034-3223
Phone number:
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