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1477151843
MACKENZIE RICK EVANS
LODI, CA
NPI
1477151843
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2020-10-16
Last Update Date
2020-10-26
Business Address
Mr. MACKENZIE RICK EVANS
541 S HAM LN
LODI, CA 95242-3530
Phone number: 209-747-7147
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Mailing Address
Mr. MACKENZIE RICK EVANS
541 S HAM LN STE A&B
LODI, CA 95242-3530
Phone number:
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