Individual
TERRI ANN JOY MARSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
111 S 5TH ST, DOUGLAS, WY 82633-2434
(307) 358-7300
Mailing address
4140 CENTENNIAL HILLS BLVD STE A, CASPER, WY 82609-3265
(307) 472-8871
(307) 235-6262
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
TL405
WY
363AM0700X
Medical Physician Assistant
TL405
WY
363AS0400X
Surgical Physician Assistant
Primary
TL405
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123939200
—
WY
Enumeration date
11/14/2006
Last updated
11/13/2018
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