Organization
BIENE STAR CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER GOSSER (CEO)
(307) 256-2155
Entity
Organization
Contact information
Practice address
6215 CLEAR CREEK PKWY, CHEYENNE, WY 82007-1951
(307) 256-2155
Mailing address
6215 CLEAR CREEK PKWY, CHEYENNE, WY 82007-1951
(307) 256-2155
Taxonomy
Speciality
Code
Description
License number
State
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
Primary
2345A
WY
Other
Enumeration date
08/15/2012
Last updated
09/18/2012
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