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Individual

DUANE LEROY WIRTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
L.ADC

Contact information

Practice address
4110 AVE D, SCOTTSBLUFF, NE 69361
(308) 635-3171
Mailing address
1851 22ND STREET, MITCHELL, NE 69357

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
528
NE

Other

Enumeration date
10/02/2006
Last updated
07/08/2007
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