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Individual

JACOB EUGENE BELYEU I

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
C.M.T

Contact information

Practice address
501 W LAKEWAY RD, D, GILLETTE, WY 82718-6146
(307) 363-3519
Mailing address
501 W LAKEWAY RD, D, GILLETTE, WY 82718-6146
(307) 363-3519

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
CO

Other

Enumeration date
11/21/2011
Last updated
11/21/2011
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