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1285904326
MARK RICHARDSON FOWLIS
RANCHO CUCAMONGA, CA
NPI
1285904326
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2012-01-06
Last Update Date
2012-01-06
Business Address
-- MARK RICHARDSON FOWLIS CAADE
11777 SEBASTIAN WAY STE 102
RANCHO CUCAMONGA, CA 91730
Phone number: 909-838-0044
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Mailing Address
-- MARK RICHARDSON FOWLIS CAADE
11777 SEBASTIAN WAY STE 102
RANCHO CUCAMONGA, CA 91730
Phone number: 909-838-0044
Copy
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