Organization
VEIN TREATMENT CENTER OF CHEYENNE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA K SURBRUGG MD (MANAGING PARTNER)
(307) 635-0226
Entity
Organization
Contact information
Practice address
4003 RAWLINS ST. SUITE B, CHEYENNE, WY 82001
(307) 637-5600
(307) 637-0249
Mailing address
123 WESTERN HILLS BLVD., CHEYENNE, WY 82009-3446
(307) 638-5149
(307) 635-1924
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121833600
—
WY
Enumeration date
03/31/2006
Last updated
06/23/2023
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