Individual
TRISTAN CHARLES BIRKEMEIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
503 S 18TH ST, LARAMIE, WY 82070-4303
(307) 742-3728
Mailing address
1213 FETTERMAN DR, LARAMIE, WY 82070-4642
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
337173
WY
224Z00000X
Occupational Therapy Assistant
Primary
COTA-1130
WY
Other
Enumeration date
12/18/2023
Last updated
12/18/2023
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