Individual
GARY W VOLLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
502 SOUTH 4TH, BASIN, WY 82410-0332
(307) 568-2047
Mailing address
PO BOX 332, 502 S. 4TH, BASIN, WY 82410-0332
(307) 568-2047
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DT-DO-184236
OR
Other
Enumeration date
12/06/2006
Last updated
07/08/2007
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