Organization
ONLINE DOCTOR OFFICE
Active
Organization
ONLINE DOCTOR OFFICE
Active
Other names
Online Doctor Office
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRY LEWIS (CIO)
(304) 639-9809
Entity
Organization
Contact information
Practice address
30 N GOULD ST STE N, SHERIDAN, WY 82801-6317
(800) 222-9375
(740) 738-0707
Mailing address
30 N GOULD ST STE N, SHERIDAN, WY 82801-6317
(800) 222-9375
(740) 738-0707
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
—
—
305S00000X
Point of Service
Primary
—
—
Other
Enumeration date
10/15/2021
Last updated
10/15/2021
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