GORDON MAX MICKELSON

ROCK SPRINGS, WY
NPI1356678270
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2009-11-13
Last Update Date2009-11-13
Business Address
-- GORDON MAX MICKELSON
3508 WHITE MOUNTAIN BLVD
ROCK SPRINGS, WY 82901-6842
Phone number: 307-389-9169
Mailing Address
-- GORDON MAX MICKELSON
3508 WHITE MOUNTAIN BLVD
ROCK SPRINGS, WY 82901-6842
Phone number: 307-389-9169
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