| Provider Type: | Other Service Providers |
| Provider Classification: | Specialist |
| Provider Specialization: | Prosthetics Case Management |
| Address: |
240 W 9th St Casper, WY 82601-3708 |
| Phone: | (307) 237-3688 |
| Fax: | (307) 237-3696 |
| Authorized Official: | Jackson, Nancy O |
| Authorized Official Position: | Office Manager |
| Authorized Official Phone: | (307) 237-3688 |
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