LEWIS PAGE WALDRON

CHEYENNE, WY
NPI1508815705
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WY  LAT 141)
Enumeration Date2006-05-08
Last Update Date2007-07-08
Business Address
Mr. LEWIS PAGE WALDRON LAT
2360 E PERSHING BLVD
CHEYENNE, WY 82001-5356
Phone number: 307-778-7324
Mailing Address
Mr. LEWIS PAGE WALDRON LAT
1610 W ALLISON RD
CHEYENNE, WY 82007-2723
Phone number: 307-635-1305