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1508380569
LOWELL OWEN WAVRICK
MISSOULA, MT
NPI
1508380569
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MT BBH-LAC-LIC-24926)
Enumeration Date
2017-08-01
Last Update Date
2022-07-21
Business Address
LOWELL OWEN WAVRICK LAC
4998 SONOMA ST
MISSOULA, MT 59808-8694
Phone number: 406-945-1730
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Mailing Address
LOWELL OWEN WAVRICK LAC
4998 SONOMA ST
MISSOULA, MT 59808-8694
Phone number: 406-945-1730
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