Organization
EAR, NOSE & THROAT CENTER OF WYOMING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVON PEFAUR (BILLING)
(801) 328-2522
Entity
Organization
Contact information
Practice address
196 ARROWHEAD DR STE 5, EVANSTON, WY 82930-8752
(801) 328-2522
Mailing address
22 S 900 E, SLC, UT 84102-1307
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
2005000496155
WY
Other
Enumeration date
05/01/2007
Last updated
08/22/2020
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