Individual
ANTHONY MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
90 GREAT OAKS BLVD, 108, SAN JOSE, CA 95119-1314
(408) 281-0708
Mailing address
90 GREAT OAKS BLVD, 108, SAN JOSE, CA 95119-1314
(408) 281-0708
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/28/2007
Last updated
07/08/2007
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