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1427811397
ANDREW JACOB BACK
FAIRFIELD, CA
NPI
1427811397
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2024-02-02
Last Update Date
2024-05-30
Business Address
ANDREW JACOB BACK
2450 MARTIN RD # 100
FAIRFIELD, CA 94534-1018
Phone number: 855-223-7123
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Mailing Address
ANDREW JACOB BACK
PO BOX 33568
SAN DIEGO, CA 92163-3568
Phone number: 855-223-7123
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