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Individual

DR. TRACY L AMMANN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
704 E FREMONT AVE, RIVERTON, WY 82501-4421
(307) 856-9000
(307) 856-9004
Mailing address
704 E FREMONT AVE, RIVERTON, WY 82501-4421
(307) 856-9000
(307) 856-9004

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
261T
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
120883700
WY
Enumeration date
10/12/2006
Last updated
07/07/2010
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