Organization
WYOMING EYE & LASER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICARDO ALFONSO AVILES M.D. (OWNER/PHYSICIAN)
(307) 371-4294
Entity
Organization
Contact information
Practice address
1005 COLLEGE VIEW DR, RIVERTON, WY 82501-2266
(307) 371-4294
(307) 857-5215
Mailing address
1005 COLLEGE VIEW DR, RIVERTON, WY 82501-2266
(307) 371-4294
(307) 857-5215
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
7754A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205837010
—
WY
Enumeration date
08/23/2007
Last updated
02/27/2008
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