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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