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1356569073
MARTIN TEFORLACK
INGLEWOOD, CA
NPI
1356569073
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-04-20
Last Update Date
2007-07-08
Business Address
-- MARTIN TEFORLACK
730 N EUCALYPTUS AVE #19
INGLEWOOD, CA 90302-2263
Phone number: 213-300-2985
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Mailing Address
-- MARTIN TEFORLACK
730 N EUCALYPTUS AVE #19
INGLEWOOD, CA 90302-2263
Phone number: 213-300-2985
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