Most Relevant Information
Provider Data
| NPI Number: | 1003529942 |
| Provider Name: | SHAY BALES |
| Entity Type: | Individual |
| Taxonomy Code: | 171000000X |
| Specialty: | Military Health Care Provider |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/05/2023 |
| Last Updated: | 01/05/2023 |
Provider Practice Location
333 S JONES ST LOT 4
POWELL
WY
824353103
Practice Location Phone/Fax
| Phone: | 3072198509 |
| Fax: |
Provider Mailing Location
333 S JONES ST LOT 4
POWELL
WY
824353103
Provider Mailing Phone/Fax
| Phone: | 3072198509 |
| Fax: |