Provider First Line Business Practice Location Address:
1000 E UNIVERSITY AVE DEPT 3195
Provider Second Line Business Practice Location Address:
KNIGHT HALL 222
Provider Business Practice Location Address City Name:
LARAMIE
Provider Business Practice Location Address State Name:
WY
Provider Business Practice Location Address Postal Code:
82071-2000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
307-766-2398
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/21/2005