Individual
MR. CHARLES JAMES AVERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAC III
Contact information
Practice address
410 RAILROAD AVE., FORT MORGAN, CO 80701
(970) 370-3940
Mailing address
902 RAM AVE., FORT MORGAN, CO 80701
(970) 370-3940
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1596-01
CO
Other
Enumeration date
12/24/2008
Last updated
12/24/2008
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