Provider Demographics
NPI:1982916854
Name:AMANN, STEVEN WAYNE
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:WAYNE
Last Name:AMANN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 JEFFERSON STREET
Mailing Address - Street 2:P.O. BOX 1547
Mailing Address - City:AFTON
Mailing Address - State:WY
Mailing Address - Zip Code:83110-1547
Mailing Address - Country:US
Mailing Address - Phone:307-220-7629
Mailing Address - Fax:
Practice Address - Street 1:519 JEFFERSON STREET
Practice Address - Street 2:
Practice Address - City:AFTON
Practice Address - State:WY
Practice Address - Zip Code:83110-1547
Practice Address - Country:US
Practice Address - Phone:307-220-7629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-08
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services