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1558994418
FREDERICK RUEL MACK
LOS ANGELES, CA
NPI
1558994418
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2020-02-19
Last Update Date
2020-02-19
Business Address
FREDERICK RUEL MACK
4445 BURNS AVE
LOS ANGELES, CA 90029-2702
Phone number: 323-664-8969
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Mailing Address
FREDERICK RUEL MACK
4445 BURNS AVE
LOS ANGELES, CA 90029-2702
Phone number: 323-664-8969
Copy
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