Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. JACK GARY GOLLA, QBA
Active Sole ProprietorMR. JACK GARY GOLLA, QBA is a Community/Behavioral Health healthcare provider located in CARSON CITY, Nevada. NPI 1780985721 is currently active in the NPPES registry. Verify at CMS.
Community/Behavioral Health · CARSON CITY, NV
Registration Details
- NPI Number
- 1780985721
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 8, 2010 (15.776844436935 yrs)
- Last Updated
- Nov 8, 2010
- License
-
FF467210 (NV)
- Sole Proprietor
- Yes
Practice Information
- Address
-
670 WASHOE DRCARSON CITY, NV, 897049528Browse NV providers · Browse ZIP 89704
- Phone
- 7758493165
- Fax
- 7758499425
- Primary Specialty
-
Community/Behavioral Health
251S00000X
Other Community/Behavioral Health Providers in CARSON CITY, NV
| Name | Credential | NPI |
|---|---|---|
| MRS. JEAN CAROLINE GOLLA | QBA | 1730489998 |
| MISS THERESA L SIMMONS | — | 1790020550 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.