Individual
DR. MARY JO KRAHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3718 PIONEER AVE, CHEYENNE, WY 82001-1246
(970) 420-2839
Mailing address
750 ASHFORD LN, FORT COLLINS, CO 80526-3920
(970) 420-2839
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
381
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120738500
PROVIDER NUMBER
WY
Enumeration date
03/14/2007
Last updated
07/08/2007
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