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1609003946
ROSEVELT JOSEPH FLUELLEN
CHEYENNE, WY
NPI
1609003946
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
251C00000X Day Training, Developmentally Disabled Services
(Licence: ND 1042)
Enumeration Date
2009-06-14
Last Update Date
2009-06-14
Business Address
Mr. ROSEVELT JOSEPH FLUELLEN LSW
4413 E 8TH ST
CHEYENNE, WY 82001-6832
Phone number: 218-280-2988
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Mailing Address
Mr. ROSEVELT JOSEPH FLUELLEN LSW
4413 E 8TH ST
CHEYENNE, WY 82001-6832
Phone number: 218-280-2988
Copy
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