Individual
JOSEPH JAMES NIVERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
510 W 29TH ST, CHEYENNE, WY 82001-2760
(307) 429-9424
Mailing address
1580 ANDOVER DR, CHEYENNE, WY 82001-1617
(307) 429-9424
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
165
WY
Other
Enumeration date
05/08/2024
Last updated
05/08/2024
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