Individual
MR. JEREMIAH JAMES HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.H.T.
Contact information
Practice address
721 W MAPLE ST, RAWLINS, WY 82301-5447
(307) 324-7156
Mailing address
203 E STATE ST, RAWLINS, WY 82301-6338
(307) 321-4752
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
06/12/2007
Last updated
07/08/2007
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