Healthcare Provider Details

I. General information

NPI: 1033049507
Provider Name (Legal Business Name): MRS. SHELLY R RISNER-VOSSLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 BLUEGRASS CIR STE 110
CHEYENNE WY
82009-7363
US

IV. Provider business mailing address

PO BOX 20634
CHEYENNE WY
82003-7014
US

V. Phone/Fax

Practice location:
  • Phone: 307-286-1449
  • Fax:
Mailing address:
  • Phone: 307-286-1449
  • Fax: 307-316-0445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: