Individual
JERRY LAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2411 LARKSPUR LN APT 56, SACRAMENTO, CA 95825-4186
(916) 529-2876
Mailing address
2411 LARKSPUR LN APT 56, SACRAMENTO, CA 95825-4186
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
A7315505
CA
Other
Enumeration date
04/15/2015
Last updated
04/15/2015
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