| Doctor Name: | ERICA ROSE GOLON |
| NPI Number: | 1568713311 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 29 Black Coal Road Fort Washakie, WY - 82514 |
| Business Phone Number: | 3078569281 |
| Business Fax Number: | |
| Mailing Address: | 14 Great Plains Rd, ARAPAHOE |
| State: | WY |
| Postal Code: | 82510 |
| Phone Number: | 3078569281 |
| Fax Number: | |
| NPI Enumeration Date: | 09/19/2012 |
| NPI Last Update Date: | 09/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 246QM0706X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Spec/Tech, Pathology |
| Taxonomy Specialization: | Medical Technologist |
| Taxonomy Definition: | |