Individual
WILLIMA B FOWLER II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2241 FARNUM ST STE 102, CASPER, WY 82609-4108
(307) 259-6093
(307) 337-1320
Mailing address
PO BOX 50295, CASPER, WY 82605-0295
(307) 259-6093
(307) 337-1320
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/30/2021
Last updated
08/30/2021
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