Individual
SHAD FREDRICK CRAPO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
195 FEATHER WAY, EVANSTON, WY 82930-9352
(307) 200-9200
Mailing address
195 FEATHER WAY, EVANSTON, WY 82930-9352
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
11/26/2018
Last updated
11/26/2018
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