Organization
FREMONT VISION CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACY L. AMMANN (O.D)
(307) 856-9000
Entity
Organization
Contact information
Practice address
704 E FREMONT AVE, RIVERTON, WY 82501-4421
(307) 856-9000
Mailing address
704 E FREMONT AVE, RIVERTON, WY 82501-4421
(307) 856-9000
(907) 856-9004
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120883700
—
WY
Enumeration date
11/08/2006
Last updated
07/15/2010
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