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1205132586
MICHEL LARS BACON
CHEYENNE, WY
NPI
1205132586
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
251C00000X Day Training, Developmentally Disabled Services
Enumeration Date
2011-02-02
Last Update Date
2011-02-02
Business Address
Mr. MICHEL LARS BACON
102 W 27TH ST
CHEYENNE, WY 82001-3041
Phone number: 307-529-0164
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Mailing Address
Mr. MICHEL LARS BACON
102 W 27TH ST
CHEYENNE, WY 82001-3041
Phone number: 307-529-0164
Copy
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