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1689368615
GERROD HERNDON
SAN RAFAEL, CA
NPI
1689368615
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder
(Licence: CA 15464)
Enumeration Date
2023-06-05
Last Update Date
2023-06-05
Business Address
GERROD HERNDON SUDRC #15464
603 D ST
SAN RAFAEL, CA 94901-3719
Phone number: 707-331-5575
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Mailing Address
GERROD HERNDON SUDRC #15464
603 D ST
SAN RAFAEL, CA 94901-3719
Phone number: 707-331-5575
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