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1346544269
KEITH WENDELL PAGE
FRESNO, CA
NPI
1346544269
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2011-01-06
Last Update Date
2011-01-06
Business Address
Mr. KEITH WENDELL PAGE
7170 N FINANCIAL DR STE 135
FRESNO, CA 93720-2978
Phone number: 559-221-8100
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Mailing Address
Mr. KEITH WENDELL PAGE
819 INDUSTRIAL AVE APT 2
INGLEWOOD, CA 90302-3347
Phone number: 559-389-9697
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