Organization
WYOMING PAIN MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY LEE LOW D.O. (MEDICAL DIRECTOR/CEO)
(307) 213-9713
Entity
Organization
Contact information
Practice address
707 SHERIDAN AVE, CODY, WY 82414-3409
(307) 213-9713
(180) 087-8647
Mailing address
PO BOX 2508, CODY, WY 82414-2508
(307) 213-9713
(180) 087-8647
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
8705A
WY
Other
Enumeration date
08/02/2011
Last updated
08/02/2011
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