Organization
WORTHAM VISION CARE,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BILLIE S WORTHAM M.S.,CCCA (AUDIOLOGIST/OWNER)
(307) 787-6123
Entity
Organization
Contact information
Practice address
106 S MAIN, LYMAN, WY 82937
(307) 787-6123
(307) 787-3351
Mailing address
PO BOX 429, LYMAN, WY 82937-0429
(307) 787-6123
(307) 787-3351
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T197
WY
231H00000X
Audiologist
A933
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102280600
—
WY
01
—
CN2934
RR MEDICARE
WY
Enumeration date
09/30/2008
Last updated
06/09/2009
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