JACK SELBERG

ATCHISON, KS
NPI1124216130
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: KS  LMLP0209, LCP334)
Enumeration Date2007-10-04
Last Update Date2007-10-04
Business Address
-- JACK SELBERG
1816 N 2ND ST
ATCHISON, KS 66002-1004
Phone number: 913-367-1618
Mailing Address
-- JACK SELBERG
1816 N 2ND ST
ATCHISON, KS 66002-1004
Phone number: 913-367-1618
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