Joshua J Fountain PTA

NPI 1003122615 - Specialist - 174400000X

NPI Details
NPI 1003122615
Gender Male
Enumeration Date 08/20/2010
Last Updated 08/20/2010
Entity Type Individual
Active Over 6 years ago
Practice Location
3718 PIONEER AVE
CHEYENNE WY, 82001-1246, US
Phone (307) 631-9246
Fax
Business Location
1830 CHESHIRE DR
CHEYENNE WY, 82001-1684, US
Phone (307) 631-9246
Fax
Toxanomy
Taxonomy Code 174400000X
License State Wyoming
License Number PTA0672
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According to our database, Mr. Joshua J Fountain PTA NPI is 1003122615, taxonomy code is 174400000X and license number is PTA0672, license state is located at Wyoming. Joshua J Fountain PTA physically located at 3718 Pioneer Ave, Cheyenne WY, 82001-1246. NPI Number Joshua J Fountain PTA has the Individual type.

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1003122615 NPI number is provided on an as is basis without warranty of any kind. 1003122615 is maintained by the National Plan & Provider Enumeration System. The contents of Joshua J Fountain PTA are for informational purposes only.