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1205469079
DONOVAN THOMALLA
LARAMIE, WY
NPI
1205469079
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2020-02-19
Last Update Date
2020-02-19
Business Address
DONOVAN THOMALLA
4989 N 3RD ST
LARAMIE, WY 82072-9548
Phone number: 307-745-8997
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Mailing Address
DONOVAN THOMALLA
4989 N 3RD ST
LARAMIE, WY 82072-9548
Phone number: 307-745-8997
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