Individual
STEPHANIE ANN FOUNTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
254 N CENTER ST, CASPER, WY 82601-1927
(307) 267-1703
Mailing address
721 RAWHIDE RD, EVANSVILLE, WY 82636-9708
(307) 267-1703
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
08/10/2020
Last updated
08/10/2020
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