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1285488106
ANDREW WILLIAM BOLAN
SAN PEDRO, CA
NPI
1285488106
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R1526620923)
Enumeration Date
2024-04-16
Last Update Date
2024-04-16
Business Address
ANDREW WILLIAM BOLAN RADT
132 W 10TH ST
SAN PEDRO, CA 90731-3702
Phone number: 310-514-4940
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Mailing Address
ANDREW WILLIAM BOLAN RADT
1003 S BEACON ST
SAN PEDRO, CA 90731-4324
Phone number: 310-514-4940
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