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1780962001
WADE MATTHEW BRENNAN
DOUGLAS, WY
NPI
1780962001
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2011-08-03
Last Update Date
2011-08-03
Business Address
WADE MATTHEW BRENNAN
1841 MADORA AVE
DOUGLAS, WY 82633-3057
Phone number: 307-358-2846
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Mailing Address
WADE MATTHEW BRENNAN
1841 MADORA AVE
DOUGLAS, WY 82633-3057
Phone number:
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