Individual
DUSTIN BRINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.P.C.
Contact information
Practice address
125 S DIVISION ST, POWELL, WY 82435-2409
(307) 754-7970
(307) 754-7971
Mailing address
2317 LANE 9, POWELL, WY 82435-9543
(307) 754-7970
(307) 754-7971
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
PPC-936
WY
Other
Enumeration date
01/12/2016
Last updated
01/12/2016
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