Individual
MR. GREGG ELLIS BOUGHTON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC, CSCS
Contact information
Practice address
1909 VISTA DR, LARAMIE, WY 82070-5530
(307) 745-8851
(307) 742-0961
Mailing address
5217 VIEW POINT CT, CHEYENNE, WY 82009-5679
(307) 214-1676
(307) 742-0961
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
02/03/2006
Last updated
07/08/2007
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