# UPSTREAM HEALTH SERVICES, P.C.

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

## Provider details

- **NPI number:** 1255716833
- **Authorized official:** DR. MICHAEL DUANE TRACY M.D. (CO-OWNER)
- **Authorized official phone:** (307) 254-0801

## Contact information

- **Practice address:** 250 N EVARTS ST, POWELL, WY 82435-2718
- **Practice address phone:** (307) 254-0801
- **Mailing address:** 250 N EVARTS ST, POWELL, WY 82435-2718
- **Mailing address phone:** (307) 254-0801

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 6460A | WY | Yes |
| 207R00000X | Internal Medicine Physician | 6739A | WY | — |
| 208000000X | Pediatrics Physician | 6739A | WY | — |

## Other

- **Enumeration date:** 07/24/2015
- **Last updated:** 07/24/2015