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1104811504
JEAN DENISE BASTA
CHEYENNE, WY
NPI
1104811504
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207X00000X Orthopaedic Surgery
(Licence: WY 6885A)
Enumeration Date
2005-09-13
Last Update Date
2007-10-29
Business Address
-- JEAN DENISE BASTA MD
2301 HOUSE AVE SUITE 505
CHEYENNE, WY 82001-3179
Phone number: 307-632-9261
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Mailing Address
-- JEAN DENISE BASTA MD
2301 HOUSE AVE SUITE 505
CHEYENNE, WY 82001-3179
Phone number: 307-632-9261
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