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General NPI Number Information
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NPI Number | 1932014230
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Entity Type | Organization
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Legal Business Name | STICKS LLC
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Dates
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Enumeration Date | 08/19/2026
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Last Update Date | 08/19/2026
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Provider Practice Location Address
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Address Line | 953 N MCCUE ST LOT 229
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City | LARAMIE
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State | WY
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Zip | 82072-6720
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Country | US
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Telephone | 307-761-0684
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Fax |
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Provider Business Mailing Address
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Address Line | 2201 S 15TH ST LOT 10
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City | LARAMIE
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State | WY
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Zip | 82070-5477
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | KEVIN CONTOS
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Credential |
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Telephone | 307-761-0684
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State |
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