Organization
RIVERTON PHYSICIAN PRACTICES, LLC
Active
Other names
Evergreen Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
JESS N JUDY (PRESIDENT)
(615) 372-8500
Entity
Organization
Contact information
Practice address
1005 COLLEGE VIEW DR, RIVERTON, WY 82501-2289
(307) 857-3488
(307) 857-5215
Mailing address
1005 COLLEGE VIEW DR, RIVERTON, WY 82501-2289
(307) 857-3488
(307) 857-5215
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
10/28/2010
Last updated
10/28/2010
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