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NPI Code Detail

MEDICARE: TREVOR JAMES MANSFIELD

MEDICARE: TREVOR JAMES MANSFIELD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1568792554
Entity Type Code : Individual
Provider Name (Legal Business Name) : TREVOR JAMES MANSFIELD
Provider Business Mailing Address
First Line : 2706 ANKENY WAY
Second Line :
City : ROCK SPRINGS
State : WY
Zip : 82901-5649
Country : US
Telephone Number : 307-352-6689
Fax Number : 307-352-6692
Provider Business Practice Location Address
First Line : 2706 ANKENY WAY
Second Line :
City : ROCK SPRINGS
State : WY
Zip : 82901-5649
Country : US
Telephone Number : 307-352-6689
Fax Number : 307-352-6692
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2010
Last Update Date : 01/13/2010

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Directions to “ TREVOR JAMES MANSFIELD ” Practice Location

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