Individual
SAWLEY WILDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
777 AVENUE H, POWELL, WY 82435-2260
(307) 754-2267
Mailing address
777 AVENUE H, POWELL, WY 82435-2260
(307) 754-2267
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MED-PHYS-LIC-114634
MT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/12/2016
Last updated
05/29/2024
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