Organization
SUMMIT SPINE AND NEUROSURGERY ASSOCIATES
Active
Parent organization
CHEYENNE REGIONAL MEDICAL GROUP, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHEYENNE REGIONAL MEDICAL GROUP, LLC
Authorized official
MICHELE GAUTREAU (CREDENTIALING SPECIALIST)
(307) 773-8012
Entity
Organization
Contact information
Practice address
2301 HOUSE AVE, SUITE 505, CHEYENNE, WY 82001-3176
(307) 632-9261
(307) 634-9170
Mailing address
2301 HOUSE AVE, SUITE 505, CHEYENNE, WY 82001-3176
(307) 632-9261
(307) 634-9170
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Enumeration date
08/08/2014
Last updated
08/08/2014
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