# WESTERN WYOMING MEDICAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235770249
- **Authorized official:** MR. ROBERT ALAN DAUGHERTY (MANAGER/OWNER)
- **Authorized official phone:** (318) 372-7510

## Contact information

- **Practice address:** 535 E MAIN ST, LANDER, WY 82520-3410
- **Practice address phone:** (318) 372-7510
- **Mailing address:** 1521 HILLCREST DR, LANDER, WY 82520-9776
- **Mailing address phone:** (318) 372-7510

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/01/2019
- **Last updated:** 10/01/2019