Organization
LUSK MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY M OTTERSBACH (PHYSICIAN ASSISTANT)
(307) 334-2900
Entity
Organization
Contact information
Practice address
119 WEST 3RD STREET, LUSK, WY 82225
(307) 334-2900
(307) 334-2904
Mailing address
PO BOX 930, LUSK, WY 82225-0930
(307) 334-2900
(307) 334-2904
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
07/03/2006
Last updated
08/22/2020
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