Mr. Jack Gary Golla, QBA
Mr. Jack Gary Golla, QBA is a Community/Behavioral Health Agency in Carson City, Nevada. Practices as a sole proprietor. Licensed in Nevada.
- Licensed in
- NV
- In the registry since
- 2010
Practice location Address checks out
670 Washoe DrCarson City, NV 89704-9528
Phone: (775) 849-3165
Fax: (775) 849-9425
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Specialties & licences
| Community/Behavioral Health Agency (primary) | Taxonomy 251S00000X · Licence FF467210 (NV) |
|---|
Record details
| NPI number | 1780985721 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | QBA |
| Sole proprietor | Yes |
| NPI enumerated | November 8, 2010 |
| Last updated in NPPES | November 8, 2010 |
| Mailing address | 670 Washoe Dr, Carson City, NV 89704-9528 |
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