Organization
OWL CREEK VISION CARE
Active
Organization
OWL CREEK VISION CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID WAYNE RODGERS O.D. (PRESIDENT)
(307) 332-7284
Entity
Organization
Contact information
Practice address
278 MAIN ST, LANDER, WY 82520-3128
(307) 332-7284
(307) 332-7285
Mailing address
278 MAIN ST, LANDER, WY 82520-3128
(307) 332-7284
(307) 332-7285
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124197400
—
WY
01
—
4721001
BCBS OF WY PRACTICE
WY
Enumeration date
02/21/2007
Last updated
03/26/2015
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