Individual
KELLY PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
501 S BURMA AVE, GILLETTE, WY 82716-3426
(307) 688-5000
(307) 688-5015
Mailing address
501 S BURMA AVE, GILLETTE, WY 82716-3426
(307) 688-5000
(307) 688-5015
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
04/06/2012
Last updated
04/06/2012
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