Individual
MR. SHADRICK TODD JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
604 E 25TH ST, CHEYENNE, WY 82001-3133
(307) 637-3953
(307) 638-6805
Mailing address
604 E 25TH ST, CHEYENNE, WY 82001-3133
(307) 637-3953
(307) 638-6805
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467994335
—
WY
Enumeration date
11/09/2016
Last updated
06/21/2017
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