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1811459118
MALIK JAMAL AVERY
SAN DIMAS, CA
NPI
1811459118
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2019-04-04
Last Update Date
2019-04-04
Business Address
MALIK JAMAL AVERY
762 CYPRESS ST
SAN DIMAS, CA 91773-3505
Phone number: 909-599-1227
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Mailing Address
MALIK JAMAL AVERY
762 CYPRESS ST
SAN DIMAS, CA 91773-3505
Phone number:
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