Organization
UNIVERSITY OF WYOMING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOB WALLER ATC (HEAD ATHLETIC TRAINER)
(307) 766-2323
Entity
Organization
Contact information
Practice address
1000 E UNIVERSITY AVE, LARAMIE, WY 82071-2000
(307) 766-2323
Mailing address
1000 E UNIVERSITY AVE, LARAMIE, WY 82071-2000
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
—
Other
Enumeration date
04/29/2011
Last updated
04/29/2011
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