Organization
RIVERTON PHYSICIAN PRACTICES LLC
Active
Other names
Total Foot Care & Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JESS N JUDY (PRESIDENT)
(615) 372-8500
Entity
Organization
Contact information
Practice address
2002 W SUNSET DR, SUITE 2, RIVERTON, WY 82501-2283
(307) 857-5280
(307) 857-5215
Mailing address
2002 W SUNSET DR, SUITE 2, RIVERTON, WY 82501-2283
(307) 857-5280
(307) 857-5215
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518118017
—
WY
Enumeration date
12/10/2009
Last updated
11/10/2010
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