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1902029960
GREGORY ALLEN WATERS
STOCKTON, CA
NPI
1902029960
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: CA 988887445)
Enumeration Date
2007-04-10
Last Update Date
2007-07-08
Business Address
Mr. GREGORY ALLEN WATERS
3601 PACIFIC AVE
STOCKTON, CA 95211-0110
Phone number: 209-946-2132
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Mailing Address
Mr. GREGORY ALLEN WATERS
3601 PACIFIC AVE
STOCKTON, CA 95211-0110
Phone number: 209-946-2132
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