Individual
CHISUM BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
401 S 23RD ST, WORLAND, WY 82401-3725
(307) 347-6165
(307) 347-6166
Mailing address
401 S 23RD ST, WORLAND, WY 82401-3725
(307) 347-6165
(307) 347-6166
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
11/01/2021
Last updated
12/14/2021
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