Individual
MR. ROSEVELT JOSEPH FLUELLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
4413 E 8TH ST, CHEYENNE, WY 82001-6832
(218) 280-2988
Mailing address
4413 E 8TH ST, CHEYENNE, WY 82001-6832
(218) 280-2988
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
1042
ND
Other
Enumeration date
06/14/2009
Last updated
06/14/2009
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