Individual
DJ LYLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2119 S JEFFERSON ST, CASPER, WY 82601-5508
(307) 797-3302
Mailing address
2119 S JEFFERSON ST, CASPER, WY 82601-5508
(307) 797-3302
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
03/11/2016
Last updated
03/11/2016
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