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Individual

TIFFANY DIANN HARDERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPO

Contact information

Practice address
2016 S GREELEY HWY UNIT 16B, CHEYENNE, WY 82007-3793
(307) 316-3098
Mailing address
1740 DELL RANGE BLVD STE H, BOX 265, CHEYENNE, WY 82009-4946
(307) 316-3098
(252) 429-7697

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
CPO04209
NC
224P00000X
Prosthetist
Primary
CPO04209
NC

Other

Enumeration date
06/20/2019
Last updated
05/16/2022
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