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1477830800
STACEY BYRUM
GILLETTE, WY
NPI
1477830800
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: WY 008)
Enumeration Date
2011-11-14
Last Update Date
2011-11-14
Business Address
-- STACEY BYRUM
1000 CAMEL DR
GILLETTE, WY 82716-4950
Phone number: 307-687-0369
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Mailing Address
-- STACEY BYRUM
2907 SILVER AVE
GILLETTE, WY 82716-1601
Phone number: 307-686-7634
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