Search › Wyoming › 1041C0700X
Juan Hernandez-Codallos
NPI 1740613306 · on the registry since 2013
Practice
- Address
- 615 Roger Canyon Rd
Laramie, WY 82072 - Phone
- (209) 918-8761
- Clinicians at this address
- 2
Additional practice sites
- 1263 N 15th St, Laramie, WY
- 1263 N 15th St, Laramie, WY
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Also registered as
- 101YP2500X
171M00000X - Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2023-07-31
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wyoming