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1952061152
ALEX JOHN DETURCK
SAN LUIS OBISPO, CA
NPI
1952061152
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2021-12-29
Last Update Date
2023-04-20
Business Address
ALEX JOHN DETURCK
1255 KENDALL RD
SAN LUIS OBISPO, CA 93401-8750
Phone number: 805-781-3535
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Mailing Address
ALEX JOHN DETURCK
1117 VISTA DEL LAGO
SAN LUIS OBISPO, CA 93405-4832
Phone number: 650-474-1266
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