Healthcare Provider Details

I. General information

NPI: 1730342452
Provider Name (Legal Business Name): KENDRA SNOW SIMS DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2008
Last Update Date: 04/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 WEST ROCHESTER
SARATOGA WY
82331-9999
US

IV. Provider business mailing address

3 WILDWOOD RD
MCFADDEN WY
82083-9999
US

V. Phone/Fax

Practice location:
  • Phone: 307-326-3324
  • Fax: 307-326-3326
Mailing address:
  • Phone: 307-326-3324
  • Fax: 307-326-3326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number680
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: