Individual
MARK JORDAN AGRESOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4425 CAMINO PAROCELA, PALM SPRINGS, CA 92264
(760) 413-2998
Mailing address
4425 E CAMINO PAROCELA, PALM SPRINGS, CA 92264-1451
(760) 413-2998
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
00859592
CA
Other
Enumeration date
02/13/2017
Last updated
02/13/2017
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