Individual
DALLON JAY DEWEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1424 17 MILE RD, RIVERTON, WY 82501-8600
(307) 851-5408
Mailing address
PO BOX 82, FORT WASHAKIE, WY 82514-0082
(307) 349-5648
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/20/2021
Last updated
12/20/2021
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