Individual
PARVANAE PENTICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
350 CITY VIEW DR STE 206, EVANSTON, WY 82930-5326
(307) 789-7915
(307) 789-6009
Mailing address
350 CITY VIEW DR STE 206, EVANSTON, WY 82930-5326
(307) 789-7915
(307) 789-6009
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
12/07/2016
Last updated
12/07/2016
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