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Individual

DR. NATHAN DARRELL EDWARDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1328 E 12TH ST, CASPER, WY 82601-3912
(307) 237-8713
(307) 237-5740
Mailing address
1328 E 12TH ST, CASPER, WY 82601-3912
(307) 237-8713
(307) 237-5740

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
337T
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
337T
STATE OF WYOMING BOARD OF OPTOMETRY
WY
Enumeration date
05/27/2010
Last updated
01/22/2020
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