Individual
MS. PEGGY RUTH CHEATHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
317 S DAY ST, POWELL, WY 82435
(307) 272-6805
Mailing address
317 S DAY ST, POWELL, WY 82435-2913
(307) 272-6805
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0142464500
—
WY
Enumeration date
10/02/2017
Last updated
08/23/2018
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