JOHN S PTACK

LEMON GROVE, CA
NPI1578792487
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2009-07-13
Last Update Date2009-07-13
Business Address
Mr. JOHN S PTACK
2049 SKYLINE DR
LEMON GROVE, CA 91945-4221
Phone number: 619-465-7303
Mailing Address
Mr. JOHN S PTACK
PO BOX 153216
SAN DIEGO, CA 92195-3216
Phone number: 619-517-2327
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