Organization
EMERGENCY ASSOCIATES OF WYOMING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA A LONG (OFFICE MANAGER)
(303) 759-0854
Entity
Organization
Contact information
Practice address
214 E 23RD ST, CHEYENNE, WY 82001-3748
(307) 634-2273
(303) 633-7671
Mailing address
1241 W MINERAL AVE, SUITE 100, LITTLETON, CO 80120-5685
(303) 759-0854
(303) 759-0864
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120962100
—
WY
Enumeration date
07/25/2006
Last updated
05/14/2008
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