Individual
THAD L ACKERMAN SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
720 WOOD ST, EUREKA, CA 95501-4413
(707) 268-2990
Mailing address
1291 JULIENTON DR NE, TOWNSEND, GA 31331-5011
(912) 660-3652
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
95108869
CA
Other
Enumeration date
08/22/2017
Last updated
08/22/2017
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