Individual
MS. SUSAN L ZUKAUCKAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10812 E POLO PLATE, CHEYENNE, WY 82009-9286
(307) 630-8710
Mailing address
10812 E POLO PLATE, CHEYENNE, WY 82009-9286
(307) 630-8710
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
WY
Other
Enumeration date
05/06/2011
Last updated
05/06/2011
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