Individual
CARMEN NEEDHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1002 FOREST DR, RIVERTON, WY 82501-2918
(307) 856-1511
Mailing address
2 S SMITH RD, RIVERTON, WY 82501-6449
(307) 856-5521
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-0306
WY
Other
Enumeration date
06/21/2008
Last updated
06/21/2008
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