Individual
VIRGINIA RENEE SPOTTED THUNDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 SHELTON ST, CHADRON, NE 69337-2312
(308) 432-8979
Mailing address
300 SHELTON ST, CHADRON, NE 69337-2312
(308) 432-8979
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/17/2020
Last updated
08/17/2020
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