GRANT A BASKO

RIVERTON, WY
NPI1255666137
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225X00000X Occupational Therapist
(Licence: WY  OTR-763)
Enumeration Date2009-10-09
Last Update Date2009-10-09
Business Address
-- GRANT A BASKO
820 W MAIN ST
RIVERTON, WY 82501-3342
Phone number: 307-857-7074
Mailing Address
-- GRANT A BASKO
PO BOX 2400
ROCK SPRINGS, WY 82902-2400
Phone number: 307-362-4336
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