Individual
MR. LEWIS PAGE WALDRON JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
2360 E PERSHING BLVD, CHEYENNE, WY 82001-5356
(307) 778-7324
Mailing address
1610 W ALLISON RD, CHEYENNE, WY 82007-2723
(307) 635-1305
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LAT 141
WY
Other
Enumeration date
05/08/2006
Last updated
07/08/2007
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