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Organization
BIG HORN BASIN CHILDREN'S CLINIC, PC
Active
Organization
BIG HORN BASIN CHILDREN'S CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT NEIL TREECE MD (OWNER)
(307) 587-5545
Entity
Organization
Contact information
Practice address
1220 SUNSHINE AVE, SUITE 101, CODY, WY 82414-4234
(307) 587-5545
Mailing address
1220 SUNSHINE AVE, SUITE 101, CODY, WY 82414-4234
(307) 587-5545
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
10190A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140893300
—
WY
Enumeration date
10/05/2016
Last updated
02/19/2018
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