Individual
JASON LEE SONDGEROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
255 N 30TH ST, LARAMIE, WY 82072-5140
(307) 742-2141
Mailing address
5418 SUMMIT DR, LARAMIE, WY 82070-5737
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
34334.1654
WY
Other
Enumeration date
09/11/2017
Last updated
09/11/2017
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