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NPI Provider: 1720085343
Contact Name: Russell Lyman Frank
Position: Administrator
Phone: (209) 369-6996
Golden State Therapy Center Information:
Golden State Therapy Center organization have npi 1720085343, taxonomy code is 261QR0401X with license number is 3016 in . This Business address located in 1235 W Vine St, Lodi, CA 95240 California. Get directions of Golden State Therapy Center.
Practice Location
Address: 1235 W Vine St, Lodi, CA 95240
Phone: (209) 369-6996
Business Location
Address: 1235 W Vine St, Lodi, CA 95240
Phone: (209) 369-6996
Fax: (209) 369-6980
Taxonomy
Taxonomy Code: 261QR0401X
License Number: 3016
License Number of State: CA
Primary Taxonomy Switch: Y
Enumeration Date: 6/29/2005
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