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Individual

MR. FLOYD DALE WILMES II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OTRL

Contact information

Practice address
1625 CHAMBERLAIN RD, CASPER, WY 82604-2737
(307) 234-8049
Mailing address
1625 CHAMBERLAIN RD, CASPER, WY 82604-2737
(307) 234-8049

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OTR-130
WY
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
OTR-130
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
112990200
WY
Enumeration date
12/15/2006
Last updated
11/12/2014
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