Organization
HOWARD MEDICAL CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN H THEDIECK MD (OWNER)
(307) 745-4884
Entity
Organization
Contact information
Practice address
3810 E GRAND AVE, LARAMIE, WY 82070-5179
(307) 745-4884
Mailing address
3810 E GRAND AVE, LARAMIE, WY 82070-5179
(307) 745-4884
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
6716A
WY
Other
Enumeration date
10/18/2007
Last updated
10/18/2007
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