Provider Information for 1982258760
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KELSEY LANE OSMOND PPC
Sex: Female
NPI: 1982258760
Last Updated: 2022-06-21
Certification Date: 2022-06-21
Certification Date: 2022-06-21
Details
| Name | Value | ||||||||||||||||||||
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| NPI | 1982258760 | ||||||||||||||||||||
| Enumeration Date | 2019-07-30 | ||||||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||||||
| Status | Active | ||||||||||||||||||||
| Mailing Address | PO BOX 847 POWELL, WY 82435-0847 United States Phone: 307-272-6036 | Fax: | ||||||||||||||||||||
| Primary Practice Address | 125 S DIVISION ST POWELL, WY 82435-2409 United States Phone: 307-272-6036 | Fax: | ||||||||||||||||||||
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