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1902532096
RICHARD THOMAS BASTUCK
WHEAT RIDGE, CO
NPI
1902532096
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CO ACC.0998499)
Enumeration Date
2022-07-29
Last Update Date
2022-07-29
Business Address
RICHARD THOMAS BASTUCK B.S., CAS
7215 W 46TH PL
WHEAT RIDGE, CO 80033-3401
Phone number: 720-961-3511
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Mailing Address
RICHARD THOMAS BASTUCK B.S., CAS
7215 W 46TH PL
WHEAT RIDGE, CO 80033-3401
Phone number: 914-400-6993
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