Individual
LARRY VENGENDEREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1909 VISTA DR, LARAMIE, WY 82070
(307) 745-8851
(307) 742-0961
Mailing address
1909 VISTA DR, LARAMIE, WY 82070
(307) 745-8851
(307) 742-0961
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
2300A
WY
Other
Enumeration date
07/28/2006
Last updated
07/08/2007
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