Individual
MICHAEL JASON SPROSTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4600 POWDERHOUSE RD, CHEYENNE, WY 82009-7324
(307) 286-3457
Mailing address
4600 POWDERHOUSE RD, CHEYENNE, WY 82009-7324
(307) 286-3457
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
015663
NY
363A00000X
Physician Assistant
Primary
PT652
WY
Other
Enumeration date
05/10/2011
Last updated
12/02/2015
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