Organization
GEM CITY BONE & JOINT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRENT KAUFMAN II (ADMINISTRATOR)
(307) 745-8851
Entity
Organization
Contact information
Practice address
1909 VISTA DR, LARAMIE, WY 82070
(307) 745-8851
(307) 742-0961
Mailing address
1909 VISTA DR, LARAMIE, WY 82070
(307) 745-8851
(307) 742-0961
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106251402
—
WY
Enumeration date
04/12/2007
Last updated
06/11/2009
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