Organization
SUNDANCE ANESTHESIA L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER S WISE M.D. (OWNER)
(208) 525-2090
Entity
Organization
Contact information
Practice address
6550 E 2ND ST, CASPER, WY 82609-4321
(307) 473-8499
(208) 525-2662
Mailing address
PO BOX 2066, IDAHO FALLS, ID 83403-2066
(208) 525-2090
(208) 525-2662
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
7797A
WY
Other
Enumeration date
06/23/2008
Last updated
06/23/2008
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