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1639546476
JIMMY CARTER
FAIRFIELD, CA
NPI
1639546476
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2015-08-27
Last Update Date
2015-08-27
Business Address
-- JIMMY CARTER
1735 ENTERPRISE DR SUITE 105A
FAIRFIELD, CA 94533-6822
Phone number: 707-425-1799
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Mailing Address
-- JIMMY CARTER
1735 ENTERPRISE DR SUITE 105A
FAIRFIELD, CA 94533-6822
Phone number: 707-425-1799
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