JERRY LEWIS ALVIN

CHEYENNE, WY
NPI1356308951
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WY  CAP046A)
Enumeration Date2006-04-27
Last Update Date2007-07-08
Business Address
Mr. JERRY LEWIS ALVIN CAP
2360 E PERSHING BLVD
CHEYENNE, WY 82001-5356
Phone number: 307-778-7550
Mailing Address
Mr. JERRY LEWIS ALVIN CAP
2360 E PERSHING BLVD
CHEYENNE, WY 82001-5356
Phone number: 307-778-7550
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