Organization
SHOWBOAT INC
Active
Organization
SHOWBOAT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RON ALAN FOOTE (OWNER)
(307) 349-1176
Entity
Organization
Contact information
Practice address
150 WYOMING ST, LANDER, WY 82520-3911
(307) 349-1176
(307) 332-2175
Mailing address
150 WYOMING ST, LANDER, WY 82520-3911
(307) 349-1176
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
116322100
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116322100
—
WY
Enumeration date
02/29/2016
Last updated
02/29/2016
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