Organization
LAGRECA EYE CLINIC PC
Active
Other names
The Eye Clinic Surgicenter
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LOLA J. PROCTOR (BILLING SUPERVISOR)
(406) 294-6586
Entity
Organization
Contact information
Practice address
1150 MAIN ST, LANDER, WY 82520-2620
(307) 332-5272
(307) 332-9481
Mailing address
2475 VILLAGE LN, #202, BILLINGS, MT 59102-2497
(406) 252-6608
(406) 252-6600
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104306400
—
WY
01
—
CK2875
WY RR MCARE
WY
Enumeration date
11/13/2007
Last updated
12/29/2011
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