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1730325986
JACK JOHNSON AVERY
DOWNEY, CA
NPI
1730325986
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2008-12-17
Last Update Date
2008-12-17
Business Address
Mr. JACK JOHNSON AVERY
9150 IMPERIAL HWY RM P-31
DOWNEY, CA 90242-2835
Phone number: 562-940-3694
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Mailing Address
Mr. JACK JOHNSON AVERY
8526 GRAPE ST
LOS ANGELES, CA 90001-4134
Phone number: 323-583-6401
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