Individual
REBECCA CHARLENE WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
FORT WASHAKIE HEALT CENTER LAB IHS 29 BLACK COAL DRIVE, FORT WASHAKIE, WY 82514
(307) 332-7672
Mailing address
811 E ADAMS AVE APT 5, RIVERTON, WY 82501-4755
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
09/28/2017
Last updated
06/16/2018
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