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Individual

MR. KENNETH W. FERBRACHE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
1115 LANE 12, LOVELL, WY 82431-9537
(307) 548-5201
(307) 548-5224
Mailing address
1115 LANE 12, LOVELL, WY 82431-9537
(307) 548-5201
(307) 548-5224

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
147
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
113013700
WY
01
970004512
MEDICARE RAILROAD
Enumeration date
08/31/2006
Last updated
09/27/2010
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