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General NPI Number Information
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NPI Number | 1023346822
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Entity Type | Organization
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Legal Business Name | ALYCE PETERS CMS
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Dates
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Enumeration Date | 12/07/2009
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Last Update Date | 12/07/2009
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Provider Practice Location Address
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Address Line | 1105 FAIRVIEW DR
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City | RIVERTON
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State | WY
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Zip | 82501-3217
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Country | US
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Telephone | 307-857-1295
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Fax |
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Provider Business Mailing Address
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Address Line | 1105 FAIRVIEW DR
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City | RIVERTON
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State | WY
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Zip | 82501-3217
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Country | US
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Telephone | 307-857-1295
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALYCE J PETERS
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Credential |
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Telephone | 307-857-1295
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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