Organization
COWBOY MEDICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WADE T BOMENGEN MD (OWNER)
(307) 347-2449
Entity
Organization
Contact information
Practice address
1125 CHARLES AVE, WORLAND, WY 82401-4021
(307) 347-2449
Mailing address
1125 CHARLES AVE, WORLAND, WY 82401-4021
(307) 347-2449
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
12/06/2017
Last updated
01/19/2018
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