Individual
JACOB E MCGRATH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14 DOGWOOD LN, LOS LUNAS, NM 87031-5904
(505) 238-9033
Mailing address
14 DOGWOOD LN, LOS LUNAS, NM 87031-5904
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
09/18/2021
Last updated
09/18/2021
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