Organization
UROLOGY CARE CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EDITH DIANE WILSON M.D. (OWNER)
(307) 632-3111
Entity
Organization
Contact information
Practice address
433 E 19TH ST, CHEYENNE, WY 82001-4643
(307) 632-3111
(307) 778-8649
Mailing address
433 E 19TH ST, CHEYENNE, WY 82001-4643
(307) 632-3111
(307) 778-8649
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
5500A
WY
Other
Enumeration date
11/09/2006
Last updated
08/22/2020
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