WALLACE LARRY KLOSTREICH

BISMARCK, ND
NPI1073540415
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: ND  1073)
Enumeration Date2006-06-28
Last Update Date2007-07-08
Business Address
WALLACE LARRY KLOSTREICH LAC
1237 W DIVIDE AVE STE 5
BISMARCK, ND 58501-1208
Phone number: 701-328-8892
Mailing Address
WALLACE LARRY KLOSTREICH LAC
1237 W DIVIDE AVE STE 5
BISMARCK, ND 58501-1208
Phone number: 701-328-8892
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