Individual
BRYAN KENNETH TIPTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, MPAS
Contact information
Practice address
777 AVENUE H, POWELL, WY 82435-2260
(307) 754-7257
(307) 754-7217
Mailing address
777 AVENUE H, POWELL, WY 82435-2260
(307) 754-2267
(307) 754-7257
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA827
WY
363AM0700X
Medical Physician Assistant
PT827
WY
Other
Enumeration date
02/01/2019
Last updated
05/25/2022
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