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1205328960
SAMUEL CARLSON
CHEYENNE, WY
NPI
1205328960
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2018-05-30
Last Update Date
2018-05-30
Business Address
SAMUEL CARLSON
2310 E 8TH ST
CHEYENNE, WY 82001-5256
Phone number: 307-632-6433
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Mailing Address
SAMUEL CARLSON
510 W 29TH ST
CHEYENNE, WY 82001-2760
Phone number: 307-426-4728
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