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Individual

JENNIFER JANET SPAIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
530 S 5TH ST, LANDER, WY 82520-3210
(307) 332-7825
(307) 332-7596
Mailing address
530 S 5TH ST, LANDER, WY 82520-3210
(307) 332-7825
(307) 332-7596

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
08/25/2009
Last updated
08/25/2009
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