NPI 1144836271

Wood M Palmer

Practitioner Peer Specialist Jackson, WY

Practice location

Address: 610 W Broadway Ave STE L1, Jackson, WY 83001-8213
Phone: (307) 733-3908
Fax: (307) 734-0017
Mailing address: PO Box 11390, Jackson, WY 83002-1390

Registered specialties

Peer Specialist Primary

Other Service Providers Taxonomy 175T00000X Licence DS-2020-057 (WY)

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Registry record

NPI: 1144836271
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 Sep 2020
Record last updated: 23 Sep 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.