LARRY KEITH CROCOMBE

PUEBLO, CO
NPI1558562488
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CO  4136)
Enumeration Date2007-05-29
Last Update Date2007-07-08
Business Address
-- LARRY KEITH CROCOMBE B.A.CACII
509 E 13TH ST
PUEBLO, CO 81001-2940
Phone number: 719-546-6666
Mailing Address
-- LARRY KEITH CROCOMBE B.A.CACII
2561 ELMWOOD LN
PUEBLO, CO 81005-2703
Phone number: 719-564-4847
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