Jade Kyle Newman, C.O.
in Cheyenne, WY. Individual provider (NPI-1).
NPI number1174064992
StatusActive
Last updated in NPPESMar 13, 2017
Details
- NPI
- 1174064992
- Entity type
- Individual (NPI-1)
- Name
- Mr. Jade Kyle Newman
- Credential
- C.O.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 13, 2017
- Last updated
- Mar 13, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 222Z00000X | C50036 | – | Yes |
Practice location
2110 Evans AveCheyenne, WY 82001
Phone 307-778-6595 · Fax 307-778-6191
Mailing address
2110 Evans AveCheyenne, WY 82001-3734
Phone 307-778-6595 · Fax 307-778-6191
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