Organization
307 LONGEVITY PC
Active
Other names
The Legacy Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER THOMA DC (OWNER)
(307) 899-0009
Entity
Organization
Contact information
Practice address
1120 BECK AVE, CODY, WY 82414-3624
(307) 527-0355
(307) 527-0360
Mailing address
PO BOX 308, WAPITI, WY 82450-0308
(307) 899-0009
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
07/06/2024
Last updated
07/06/2024
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