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1285392290
BRIAN CHILDRESS
LARAMIE, WY
NPI
1285392290
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2021-12-07
Last Update Date
2021-12-07
Business Address
BRIAN CHILDRESS
4989 N 3RD ST
LARAMIE, WY 82072-9548
Phone number: 307-745-8997
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Mailing Address
BRIAN CHILDRESS
4989 N 3RD ST
LARAMIE, WY 82072-9548
Phone number: 307-745-8997
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