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Individual

MALAIKA LOUDEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
455 W BROADWAY AVE, JACKSON, WY 83001-8639
(307) 733-8002
Mailing address
970 W. BROADWAY STE. E #398, JACKSON, WY 83001
(307) 413-7757

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary

Other

Enumeration date
06/28/2017
Last updated
06/28/2017
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