Individual
RYAN J WILCOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2100 W SUNSET DR, RIVERTON, WY 82501-2274
(800) 967-1646
Mailing address
PO BOX 32103, BILLINGS, MT 59107-2103
(317) 567-2180
(317) 567-2191
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
22518.35
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121553100
—
WY
01
—
P00435060
RAILROAD MEDICARE
WY
Enumeration date
06/20/2006
Last updated
05/17/2012
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