Individual
GUY WALTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1414 E 20TH ST, SCOTTSBLUFF, NE 69361-2712
(308) 672-2848
Mailing address
PO BOX 838, SCOTTSBLUFF, NE 69363-0838
(308) 672-2848
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/17/2024
Last updated
12/17/2024
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