MR. Jack Gary Golla, QBA
NPI #1780985721 in Carson City, Nevada
Provider Information
- NPI Number
- 1780985721
- Entity Type
- Individual
- Name
- MR. Jack Gary Golla, QBA
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Community/Behavioral Health
- Credential
- QBA
- Enumeration Date
- Nov 8, 2010
- Last Updated
- Nov 8, 2010
Practice Location
- Address
- 670 WASHOE DR
- City
- Carson City
- State
- Nevada
- ZIP Code
- 89704-9528
- Phone
- (775) 849-3165
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
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