DONALD RAY JACK

HOLLYWOOD, CA
NPI1497079875
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy146N00000X Emergency Medical Technician, Basic
(Licence: KY  12521464546464)
Enumeration Date2010-03-15
Last Update Date2010-03-15
Business Address
Mr. DONALD RAY JACK M.D.
1644 WILCOX AVE
HOLLYWOOD, CA 90028-6206
Phone number: 424-202-0322
Mailing Address
Mr. DONALD RAY JACK M.D.
180 E. PROVIDENCIA AVE.
BURBANK, CA 91205
Phone number: 424-202-0322