Organization
ANESTHESIA ASSOCIATES OF LARAMIE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN DAVID CRECCA M.D. (PRESIDENT)
(307) 760-9897
Entity
Organization
Contact information
Practice address
255 N 30TH ST, LARAMIE, WY 82072-5140
(307) 742-2141
Mailing address
PO BOX 1562, IDAHO FALLS, ID 83403-1562
(208) 525-2090
(208) 523-8978
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114752800
—
WY
Enumeration date
09/08/2006
Last updated
10/10/2016
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