Individual
DR. THANE MICHAEL MAINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2514 PARK AVE, LARAMIE, WY 82070-4860
(307) 742-9433
Mailing address
2514 PARK AVE, LARAMIE, WY 82070-4860
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD3829A
WY
Other
Enumeration date
06/25/2008
Last updated
06/25/2008
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