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Individual

MR. BERNIE LEE STRADLEY VI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2303 LANDER LN, CHEYENNE, WY 82009-9401
(307) 635-2826
Mailing address
2303 LANDER LN, CHEYENNE, WY 82009-9401
(307) 635-2826

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
251C00000X

Other

Enumeration date
02/07/2008
Last updated
02/07/2008
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