Individual
HARLIE HIMMELBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1026 E 2ND ST, CASPER, WY 82601-2902
(307) 333-0002
(307) 202-5112
Mailing address
1026 E 2ND ST, CASPER, WY 82601-2902
(402) 621-0599
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA1095
WY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/03/2022
Last updated
10/09/2024
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