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1932171998
GREGG ELLIS BOUGHTON
LARAMIE, WY
NPI
1932171998
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2006-02-03
Last Update Date
2007-07-08
Business Address
Mr. GREGG ELLIS BOUGHTON ATC, CSCS
1909 VISTA DR
LARAMIE, WY 82070-5530
Phone number: 307-745-8851
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Mailing Address
Mr. GREGG ELLIS BOUGHTON ATC, CSCS
5217 VIEW POINT CT
CHEYENNE, WY 82009-5679
Phone number: 307-214-1676
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