# FREMONT RADIOLOGY PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Fremont Radiology MRI
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124207345
- **Authorized official:** VALERIE LAWRENCE (OFFICE MANAGER)
- **Authorized official phone:** (307) 856-6530

## Contact information

- **Practice address:** 2102 W SUNSET DR, RIVERTON, WY 82501
- **Practice address phone:** (307) 856-6530
- **Mailing address:** 1001 WEST MAIN STREET, RIVERTON, WY 82501
- **Mailing address phone:** (307) 856-6530

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1200X | Magnetic Resonance Imaging (MRI) Clinic/Center | FDTC-300 | WY | Yes |

## Other

- **Enumeration date:** 10/25/2007
- **Last updated:** 10/25/2007