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1619287414
STANFORD B TRACHTENBERG
WILSON, WY
NPI
1619287414
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2085R0202X Radiology, Diagnostic Radiology
(Licence: WY 5033A)
Enumeration Date
2010-10-14
Last Update Date
2010-10-14
Business Address
Dr. STANFORD B TRACHTENBERG m.d.
3680 LAKE CREEK DRIVE
WILSON, WY 83014
Phone number: 307-733-3642
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Mailing Address
Dr. STANFORD B TRACHTENBERG m.d.
PO BOX 344
TETON VILLAGE, WY 83025-0344
Phone number: 307-733-3642
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