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1821367715
HOLEY MIC RUN
SACRAMENTO, CA
NPI
1821367715
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2011-12-21
Last Update Date
2011-12-21
Business Address
-- HOLEY MIC RUN
4343 WILLIAMSBOURGH DR
SACRAMENTO, CA 95823-2006
Phone number: 916-395-3552
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Mailing Address
-- HOLEY MIC RUN
4732 PARKER AVE
SACRAMENTO, CA 95820-4015
Phone number: 916-370-7882
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