Individual
JOHN DAVID DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
748 MAIN ST, LANDER, WY 82520-3036
(307) 332-2231
Mailing address
748 MAIN ST, LANDER, WY 82520-3036
(307) 332-2231
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LAT-241
WY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/11/2022
Last updated
12/05/2025
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