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Organization

DIANA LEE MARTIN

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DIANA LEE MARTIN RN (OWNER)
(307) 747-8035
Entity
Organization

Contact information

Practice address
2805 STATE HIGHWAY 411, FORT BRIDGER, WY 82933
(307) 747-8035
Mailing address
PO BOX 512, FORT BRIDGER, WY 82933-0512
(307) 747-8035

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary

Other

Enumeration date
08/22/2024
Last updated
08/22/2024
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