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1992011167
PHILLIP M. CHURCH
YUCCA VALLEY, CA
NPI
1992011167
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2010-08-26
Last Update Date
2010-08-26
Business Address
-- PHILLIP M. CHURCH
55475 SANTA FE TRL
YUCCA VALLEY, CA 92284-3117
Phone number: 760-365-3022
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Mailing Address
-- PHILLIP M. CHURCH
55475 SANTA FE TRL.
YUCCA VALLEY, CA 92284
Phone number:
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