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1174771505
WYATT DANE CARSON
MC COOK, NE
NPI
1174771505
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NE P-628)
Enumeration Date
2008-08-27
Last Update Date
2008-08-27
Business Address
Mr. WYATT DANE CARSON PLADC
322 NORRIS AVE #5
MC COOK, NE 69001-3700
Phone number: 308-345-5592
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Mailing Address
Mr. WYATT DANE CARSON PLADC
322 NORRIS AVE #5
MC COOK, NE 69001-3700
Phone number: 308-345-5592
Copy
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