Individual
STEPHEN STURDIVANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
232 GAMBELL ST, HARTVILLE, WY 82215-5000
(307) 836-2294
Mailing address
PO BOX 56, HARTVILLE, WY 82215-0056
(307) 836-2294
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/23/2019
Last updated
09/01/2020
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