JODY FAXON

CASPER, WY
NPI1932482387
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: WY  PTA0305)
Enumeration Date2011-09-22
Last Update Date2011-09-22
Business Address
-- JODY FAXON PTA
6631 E 2ND ST
CASPER, WY 82609-4355
Phone number: 307-268-9904
Mailing Address
-- JODY FAXON PTA
6631 E 2ND ST
CASPER, WY 82609-4355
Phone number: 307-268-9904
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