Healthcare Provider Details

I. General information

NPI: 1578053153
Provider Name (Legal Business Name): DEVON KUHLMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2018
Last Update Date: 05/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

152 HILLVIEW DR.
AFTON WY
83110
US

IV. Provider business mailing address

PO BOX 602
AFTON WY
83110-0602
US

V. Phone/Fax

Practice location:
  • Phone: 307-887-5496
  • Fax:
Mailing address:
  • Phone: 307-887-5496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: