Individual
DR. NICHOLAS HENRY HASTERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
330 UPLAND WAY, GREEN RIVER, WY 82935
(307) 875-4654
Mailing address
210 SUMMERVIEW DR, GREEN RIVER, WY 82935-5454
(307) 871-4922
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1716
WY
Other
Enumeration date
06/15/2017
Last updated
06/15/2017
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