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-- GRANT A BASKO --

Individual Provider (NPI-1) Active

Occupational Therapist

Provider Information

NPI Number
1255666137
Provider Type
Individual Provider (NPI-1)
Status
Active

Contact & Location

Address
820 W MAIN ST, RIVERTON, WY, 825013342
Phone
(307) 857-7074
Fax
(307) 856-6459

Specialties & Taxonomies

Occupational Therapist Primary License: WY #OTR-763

All Addresses

MAILING

PO BOX 2400

ROCK SPRINGS, WY, 829022400

(307) 362-4336

LOCATION

820 W MAIN ST

RIVERTON, WY, 825013342

(307) 857-7074