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Individual

JASON MATTHEW IPPOLITO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1603 CAPITOL AVE STE 413C1029, CHEYENNE, WY 82001-4569
(951) 640-0321
Mailing address
1603 CAPITOL AVE STE 413C1029, CHEYENNE, WY 82001-4569
(951) 640-0321

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
WY

Other

Enumeration date
09/04/2025
Last updated
09/05/2025
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