JACOB LEVI MONTANA SWAN

LARAMIE, WY
NPI1952277378
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: WY  PTA-0860)
Enumeration Date2025-10-13
Last Update Date2025-10-13
Business Address
JACOB LEVI MONTANA SWAN PTA
1609 PALOMINO DR
LARAMIE, WY 82070-5393
Phone number: 307-299-0131
Mailing Address
JACOB LEVI MONTANA SWAN PTA
1609 PALOMINO DR
LARAMIE, WY 82070-5393
Phone number: 307-299-0131
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