Organization
TETON PATHOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARS CONWAY M.D. (PRESIDENT)
(612) 801-6060
Entity
Organization
Contact information
Practice address
625 E BROADWAY AVE, JACKSON, WY 83001-8642
(307) 733-3636
Mailing address
PO BOX 4940, JACKSON, WY 83001-4940
(612) 801-6060
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
9164A
WY
Other
Enumeration date
04/08/2013
Last updated
04/08/2013
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