Individual
KATHLEEN ANN DIVINCENZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
707 SHERIDAN AVE, CODY, WY 82414
(307) 578-2480
(307) 578-2492
Mailing address
707 SHERIDAN AVE, CODY, WY 82414
(307) 578-2480
(307) 578-2492
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4494A
WY
Other
Enumeration date
06/13/2006
Last updated
10/05/2020
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