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1538366505
ALFREDO ANTILLON
GREEN RIVER, WY
NPI
1538366505
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
251C00000X Day Training, Developmentally Disabled Services
Enumeration Date
2007-07-02
Last Update Date
2007-07-08
Business Address
Mr. ALFREDO ANTILLON
720 WIND RIVER DR B
GREEN RIVER, WY 82935-5725
Phone number: 307-875-5781
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Mailing Address
Mr. ALFREDO ANTILLON
720 WIND RIVER DR B
GREEN RIVER, WY 82935-5725
Phone number: 307-875-5781
Copy
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