Organization
HOLE ORTHO LLC
Active
Organization
HOLE ORTHO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA ASHLEY SJOSTROM MD (OWNER)
(307) 699-6801
Entity
Organization
Contact information
Practice address
555 E BROADWAY AVE STE 211, JACKSON, WY 83001-8640
(307) 699-6801
(307) 733-6912
Mailing address
970 W BROADWAY STE E121, JACKSON, WY 83001-6402
(307) 699-6801
(307) 733-6912
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
08/04/2023
Last updated
04/29/2024
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