Individual
MR. JARON FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
136 W 21ST AVE, TORRINGTON, WY 82240-2721
(307) 532-2119
Mailing address
2321 ROAD 116, FORT LARAMIE, WY 82212-7634
(307) 837-2050
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
PPC-988
WY
Other
Enumeration date
01/13/2017
Last updated
01/13/2017
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