Individual
KELSIE LEIGH MICHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3986 PARADISE RD, CARPENTER, WY 82054-9105
(307) 287-3128
Mailing address
3986 PARADISE RD, CARPENTER, WY 82054-9105
(307) 287-3128
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Enumeration date
12/02/2019
Last updated
12/02/2019
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