Organization
LIVING WATERS COORDINATED COMMUNITIES, INC.
Active
Other names
Pain Management Psychology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAVERL H WILHELM PHD (PRESIDENT, PSYCHOLOGIST)
(208) 676-0926
Entity
Organization
Contact information
Practice address
2108 N IRONWOOD CENTER DR, COEUR D ALENE, ID 83814
(208) 676-0926
(208) 676-0926
Mailing address
212 W IRONWOOD DR, SUITE D311, COEUR D ALENE, ID 83814-1403
(208) 676-0926
(208) 676-0926
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
PSYCHOLOGY 202060
ID
Other
Enumeration date
04/17/2007
Last updated
09/28/2007
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