Organization
ALYCE PETERS CMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALYCE JEAN PETERS (OWNER)
(307) 857-1295
Entity
Organization
Contact information
Practice address
1105 FAIRVIEW DR, RIVERTON, WY 82501-3217
(307) 857-1295
Mailing address
1105 FAIRVIEW DR, RIVERTON, WY 82501-3217
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/10/2010
Last updated
03/10/2010
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