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Individual

ZACHORY FRED DEISS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1522 E A ST, CASPER, WY 82601-2217
(307) 234-6161
Mailing address
1000 ROAD 9, POWELL, WY 82435-9225

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4193A
WY

Other

Enumeration date
11/29/2006
Last updated
10/22/2012
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