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1588016208
AVERY COLEMAN
SAN BERNARDINO, CA
NPI
1588016208
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
167G00000X Licensed Psychiatric Technician
(Licence: CA 22523)
Enumeration Date
2016-07-06
Last Update Date
2016-07-06
Business Address
-- AVERY COLEMAN
2080 S E ST
SAN BERNARDINO, CA 92408-2773
Phone number: 909-388-9191
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Mailing Address
-- AVERY COLEMAN
2080 S E ST
SAN BERNARDINO, CA 92408-2773
Phone number: 909-388-9191
Copy
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