Individual
TRENTON VONBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2744 FAIRDALE AVE, CASPER, WY 82601
(307) 534-6165
Mailing address
2744 FAIRDALE AVE, CASPER, WY 82601
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
COTA-865
WY
Other
Enumeration date
08/28/2016
Last updated
08/28/2016
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