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1720450513
ELVIS PERCY
POMONA, CA
NPI
1720450513
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2015-10-20
Last Update Date
2015-10-20
Business Address
-- ELVIS PERCY
2180 VALLEY BLVD
POMONA, CA 91768-3325
Phone number: 909-865-2336
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Mailing Address
-- ELVIS PERCY
2180 VALLEY BLVD
POMONA, CA 91768-3325
Phone number: 909-865-2336
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