Organization
FRONTIER ORTHOPEDIC SERVICES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES FREDERICK JACKSON BOCP (OWNER/PRACTITIONER)
(307) 637-3131
Entity
Organization
Contact information
Practice address
611 E. CARLSON STREET, SUITE 115, CHEYENNE, WY 82009-4311
(307) 637-3131
(307) 637-4405
Mailing address
611 E. CARLSON STREET, SUITE 115, CHEYENNE, WY 82009-4311
(307) 637-3131
(307) 637-4405
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
C12686
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119925100
—
WY
01
—
306400
BC/BS
WY
Enumeration date
08/11/2006
Last updated
04/04/2012
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