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ERIC ALLISON

>> Community Health Worker >> Other Service Providers

Registrant NPI Number: 1720254238

Individual Registrant:
 ERIC  ALLISON 
Gender: M
Sole Proprietor

Location and contact information for practice:
15095 AMARGOSA RD 101 VICTORVILLE, CA 92394-1879 US
Tel: 760-245-4695  Fax: 760-245-5896

Contact information for business:
15095 AMARGOSA RD 101 VICTORVILLE, CA 92394-1879 US
Tel: 760-245-4695  Fax: 760-513-4696

Registration Information:
NPI: 1720254238
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y172V00000XOther Service Providers
Community Health Worker

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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