Organization
AFTER HOURS ECLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRYSTAL OUTLAW (OWNER)
(757) 748-4643
Entity
Organization
Contact information
Practice address
2232 DELL RANGE BLVD STE 245, CHEYENNE, WY 82009-4979
(945) 899-0800
Mailing address
2468 LAKELAND DR, GRAND PRAIRIE, TX 75054-6813
(757) 748-4643
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Enumeration date
07/15/2022
Last updated
07/15/2022
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