Individual
WILLIAM THOMAS CHURCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADC INTERN
Contact information
Practice address
205 S PRATT AVE, CARSON CITY, NV 89701-4730
(775) 882-3945
(775) 882-6126
Mailing address
205 S PRATT AVE, CARSON CITY, NV 89701-4730
(775) 882-3945
(775) 882-6126
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
00924-I
NV
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
06/04/2013
Last updated
06/19/2013
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