Individual
MRS. MILSOM JUNE BAIELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
710 W MAIN ST, RIVERTON, WY 82501-3340
(307) 856-7182
Mailing address
2004 W PARK AVE, RIVERTON, WY 82501-3135
(307) 856-7078
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3148430
PROVIDER NUMBER
WY
Enumeration date
01/24/2009
Last updated
01/24/2009
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