Cisco John Oldani

Individual provider Active NPI Respite Care · Wilson, WY

NPI 1962647016 · NPPES record last updated Dec 3, 2008

Key facts

NPI
1962647016
Entity type
Individual (NPI type 1)
Primary specialty
Respite Care 385H00000X
Practice address
2245 Coyote Loop
Wilson, WY 83014-9668
Phone
(307) 690-9817
NPI assigned
Dec 3, 2008
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Respite Care 385H00000X Yes

Addresses

Primary practice location

2245 Coyote Loop
Wilson, WY 83014-9668

Mailing address

2245 Coyote Loop
Wilson, WY 83014-9668
Phone (307) 690-9817

Other providers in Wilson, WY

All providers in Wilson, WY · Respite Care in Wyoming

Sources for this page

Verify at the official NPI Registry.