Organization
US DEPT OF HHS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM WADE OHLSON RN (REGISTERED NURSE)
(307) 752-6723
Entity
Organization
Contact information
Practice address
100 CHEYENNE AVE, LAME DEER, MT 59043-0070
(406) 477-8848
Mailing address
PO BOX 70, LAME DEER, MT 59043-0070
(406) 477-8848
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
17679
WY
Other
Enumeration date
11/29/2011
Last updated
11/29/2011
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