Individual
MRS. MARY JANE FAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
501 S BURMA AVE, GILLETTE, WY 82716-3426
(307) 688-5050
Mailing address
1919 ZIEBACH ST, BELLE FOURCHE, SD 57717-7308
(605) 723-4301
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28164
WY
Other
Enumeration date
04/03/2012
Last updated
04/03/2012
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