Individual
CHARLES WASSUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
120 S 17TH ST, WORLAND, WY 82401-3637
(307) 347-4001
Mailing address
120 S 17TH ST, WORLAND, WY 82401-3637
(307) 347-4001
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1320
WY
Other
Enumeration date
11/01/2013
Last updated
06/09/2014
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