Individual
MARLENA THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
165 E RAILROAD AVE, GREEN RIVER, WY 82935-4354
(307) 871-8696
Mailing address
911 DAVY CROCKETT DR, GREEN RIVER, WY 82935-5629
(307) 871-8696
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
07/27/2010
Last updated
07/27/2010
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