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Individual

SANDRA LOU RICKARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
915 S DAVID ST, CASPER, WY 82601-3737
(307) 472-3769
(307) 472-3707
Mailing address
915 S DAVID ST, CASPER, WY 82601-3737
(307) 472-3769
(307) 472-3707

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
N/A
NON MEDICAID
WY
Enumeration date
02/03/2017
Last updated
02/03/2017
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