DENNIS MARK MATLOCK

INDIO, CA
NPI1457490088
Former NameDENNIS MARK MATLOCK
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2007-02-06
Last Update Date2007-07-08
Business Address
-- DENNIS MARK MATLOCK RS1503
83912 AVENUE 45 STE 9
INDIO, CA 92201-3338
Phone number: 760-347-0754
Mailing Address
-- DENNIS MARK MATLOCK RS1503
PO BOX 2023
YUCCA VALLEY, CA 92286-2023
Phone number: 760-347-0754
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