Provider Demographics
NPI:1306032354
Name:GEBHART, WENDY MICHELLE (ND, LAC)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:MICHELLE
Last Name:GEBHART
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 SHRINE CLUB RD
Mailing Address - Street 2:
Mailing Address - City:LANDER
Mailing Address - State:WY
Mailing Address - Zip Code:82520-9404
Mailing Address - Country:US
Mailing Address - Phone:307-332-7888
Mailing Address - Fax:
Practice Address - Street 1:15 SHRINE CLUB RD
Practice Address - Street 2:
Practice Address - City:LANDER
Practice Address - State:WY
Practice Address - Zip Code:82520-9404
Practice Address - Country:US
Practice Address - Phone:307-332-7888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-23
Last Update Date:2007-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1534175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath