Individual
JEREMI VILLANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
713 OAK STREET, SUNDANCE, WY 82729
(307) 283-2476
(307) 283-2489
Mailing address
PO BOX 517, SUNDANCE, WY 82729-0517
(307) 283-2476
(307) 283-2255
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2541A
WY
207Q00000X
Family Medicine Physician
2740
SD
Other
Enumeration date
08/21/2006
Last updated
07/08/2007
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