FRED GAMMON

RIVERTON, KS
NPI1699192617
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: KS  1139)
Enumeration Date2014-03-27
Last Update Date2014-03-27
Business Address
FRED GAMMON T-LAC
6610 SE QUAKERVALE RD
RIVERTON, KS 66770-4185
Phone number: 620-848-2300
Mailing Address
FRED GAMMON T-LAC
PO BOX 550
RIVERTON, KS 66770-0550
Phone number: 620-848-2300