Individual
KRYSTEN GAYLE SOMMERVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
120 W PEARL AVE, JACKSON, WY 83001-8657
(307) 734-9129
Mailing address
PO BOX 2654, ALPINE, WY 83128
(432) 770-6257
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
06/09/2023
Last updated
12/30/2024
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