Individual provider · NPI-1

William Brent Blair

Durable Medical Equipment & Medical Supplies · Casper, WY

NPI number1114187572
StatusActive
Last updated in NPPESJun 24, 2008

Details

NPI
1114187572
Entity type
Individual (NPI-1)
Name
William Brent Blair
Sex
Male
Sole proprietor
Yes
Enumeration date
Jun 10, 2008
Last updated
Jun 24, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
332B00000X Durable Medical Equipment & Medical Supplies––Yes

Practice location

1347 S Wisconsin Ave
Casper, WY 82609-2936

Phone 307-234-3047 · Fax 307-234-3897

Mailing address

1347 S Wisconsin Ave
Casper, WY 82609-2936

Phone 307-234-3047 · Fax 307-234-3897

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