Individual
MR. KEITH RAYMOND WOODWORTH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1805 EDGEWATER AVE, CHEYENNE, WY 82009-7311
(307) 637-3952
Mailing address
1805 EDGEWATER AVE, CHEYENNE, WY 82009-7311
(307) 637-3952
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
WY
Other
Enumeration date
04/16/2025
Last updated
04/17/2025
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