ERIC BACON

SAINT PAUL, MN
NPI1720320013
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MN  302461)
Enumeration Date2013-03-25
Last Update Date2013-03-25
Business Address
Mr. ERIC BACON LADC
153 CESAR CHAVEZ ST
SAINT PAUL, MN 55107-2226
Phone number: 651-389-2540
Mailing Address
Mr. ERIC BACON LADC
153 CESAR CHAVEZ ST
SAINT PAUL, MN 55107-2226
Phone number: 651-389-2540
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