Individual
AMY EAGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
431 MAIN ST, LANDER, WY 82520-3145
(307) 332-2515
(307) 332-1640
Mailing address
PO BOX 1234, RIVERTON, WY 82501-0156
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/24/2021
Last updated
05/24/2021
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