Individual
STEVEN STALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
190 NORTH MAIN STREET, THAYNE, WY 83127
(307) 883-4600
Mailing address
PO BOX 1006, THAYNE, WY 83127-1006
(307) 883-4600
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2643
WY
Other
Enumeration date
11/03/2011
Last updated
11/03/2011
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