ANTHONY MACK

SAN JOSE, CA
NPI1497882997
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2007-02-28
Last Update Date2007-07-08
Business Address
-- ANTHONY MACK
90 GREAT OAKS BLVD 108
SAN JOSE, CA 95119-1314
Phone number: 408-281-0708
Mailing Address
-- ANTHONY MACK
90 GREAT OAKS BLVD 108
SAN JOSE, CA 95119-1314
Phone number: 408-281-0708