IndividualActive
Gary Wallace
NPI 1366374126 · Student in an Organized Health Care Education/Training Program · Cheyenne, WY
Provider details
- NPI number
- 1366374126
- Entity type
- Individual
- Primary specialty
- Student in an Organized Health Care Education/Training ProgramStudent, Health Care
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Student, Health Care
Practice location
820 E 17th St
Cheyenne, WY 82001-4714
Phone: (307) 632-2434
Approximate (ZIP-level) locationGet directions
Mailing address
820 E 17th St
Cheyenne, WY 82001-4714
Registry dates
- Enumerated
- 2026-06-03
- Last updated
- 2026-06-03
- Certified
- 2026-06-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.