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JACK ANDERSON

Attendant Care Provider >> Technician >> Nursing Service Related Providers

Registrant NPI Number: 1982254603

Individual Registrant:
 JACK  ANDERSON 
Gender: M
Sole Proprietor

Location and contact information for practice:
14810 LA MESA RD  VICTORVILLE, CA 92392-8639 US
Tel: 760-951-0510  Fax: --

Contact information for business:
14810 LA MESA RD  VICTORVILLE, CA 92392-8639 US
Tel: 760-951-0510  Fax: --

Registration Information:
NPI: 1982254603
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y3747A0650XNursing Service Related Providers
Technician
Attendant Care Provider

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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