MARK DWAYNE FOWLER

LOS ANGELES, CA
NPI1528133964
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2006-11-21
Last Update Date2007-07-08
Business Address
Mr. MARK DWAYNE FOWLER
1720 E 120TH ST
LOS ANGELES, CA 90059-3052
Phone number: 310-668-3404
Mailing Address
Mr. MARK DWAYNE FOWLER
2349 LA SALLE AVE
SAN BERNARDINO, CA 92407-2437
Phone number: 909-880-9085