Individual
DR. STANFORD B TRACHTENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3680 LAKE CREEK DRIVE, WILSON, WY 83014
(307) 733-3642
Mailing address
PO BOX 344, TETON VILLAGE, WY 83025-0344
(307) 733-3642
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
5033A
WY
Other
Enumeration date
10/14/2010
Last updated
10/14/2010
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