Individual
MRS. DIANA HOWELL OBRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT MPT
Contact information
Practice address
1116 MAPLE WAY, JACKSON, WY 83002-9725
(307) 733-7037
(307) 733-4955
Mailing address
PO BOX 729, WILSON, WY 83014-0729
(307) 699-7667
(307) 733-4955
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
845
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118929800
—
WY
01
—
312610
WY BCBS
WY
Enumeration date
10/21/2006
Last updated
10/29/2020
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