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1457563470
JOSE LUIS BOLANOS
BURBANK, CA
NPI
1457563470
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-05-03
Last Update Date
2007-10-10
Business Address
Mr. JOSE LUIS BOLANOS
2116 N FREDERIC ST 18646 OXNARD ST
BURBANK, CA 91504-3323
Phone number: 818-953-8926
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Mailing Address
Mr. JOSE LUIS BOLANOS
2116 N FREDERIC ST 18646 OXNARD ST
BURBANK, CA 91504-3323
Phone number: 818-953-8926
Copy
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