Organization
WESTERN WYOMING MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT ALAN DAUGHERTY (MANAGER/OWNER)
(318) 372-7510
Entity
Organization
Contact information
Practice address
535 E MAIN ST, LANDER, WY 82520-3410
(318) 372-7510
Mailing address
1521 HILLCREST DR, LANDER, WY 82520-9776
(318) 372-7510
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
10/01/2019
Last updated
10/01/2019
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