Organization
WYOMING HEALTH MEDICAL GROUP, LLC
Active
Parent organization
WYOMING MEDICAL CENTER INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
WYOMING MEDICAL CENTER INC
Authorized official
DENNIS LARAWAY (CFO)
(602) 747-4000
Entity
Organization
Contact information
Practice address
1020 E 2ND ST STE 201, CASPER, WY 82601-2955
(307) 233-0250
Mailing address
2901 N CENTRAL AVE STE 160, PHOENIX, AZ 85012-2702
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
08/23/2021
Last updated
01/13/2022
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