Individual
KYLE WILLIAM MCDERMOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PROVIDER, OWNER
Contact information
Practice address
100 VALLEY VIEW AVE, EVANSTON, WY 82930-2105
(307) 677-5119
Mailing address
100 VALLEY VIEW AVE, EVANSTON, WY 82930-2105
(307) 677-5119
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
WY
Other
Enumeration date
12/02/2017
Last updated
12/02/2017
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