Organization
WYOMING SPINE AND NEUROSURGERY ASSOCIATES,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CARRIE L MICKELSON CPC, CCS-P (BILLING MANAGER)
(307) 778-2860
Entity
Organization
Contact information
Practice address
1950 BLUEGRASS CIR, STE 170, CHEYENNE, WY 82009-7323
(307) 778-2860
(307) 778-2866
Mailing address
1950 BLUEGRASS CIR, STE 170, CHEYENNE, WY 82009-7323
(307) 778-2860
(307) 778-2866
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
6491A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115790600
—
WY
01
—
301698061
RAILROAD MEDICARE
WY
Enumeration date
05/18/2007
Last updated
07/30/2024
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