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1477822906
JERRY PRESTON BANKS
SAN JOSE, CA
NPI
1477822906
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2011-12-29
Last Update Date
2011-12-29
Business Address
Mr. JERRY PRESTON BANKS
102 S 11TH ST
SAN JOSE, CA 95112-2132
Phone number: 408-998-5191
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Mailing Address
Mr. JERRY PRESTON BANKS
102 S 11TH ST
SAN JOSE, CA 95112-2132
Phone number: 408-998-5191
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