Organization
STAR VALLEY HOME OXYGEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG KENNETH WALTHER (OWNER)
(307) 883-3445
Entity
Organization
Contact information
Practice address
118 S MAIN ST, THAYNE, WY 83127
(307) 883-3445
(307) 883-7584
Mailing address
118 S. MAIN ST., THAYNE, WY 83127
(307) 883-3445
(307) 883-7584
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Enumeration date
01/08/2009
Last updated
10/05/2009
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