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Individual

TOMMY LEE JONES II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5101 MASCOT AVE, SACRAMENTO, CA 95820-4968
(916) 761-4590
Mailing address
5101 MASCOT AVE, SACRAMENTO, CA 95820-4968
(916) 761-4590

Taxonomy

Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
7NCR501
CA

Other

Enumeration date
03/24/2018
Last updated
03/24/2018
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