Organization
FORTIFY WYOMING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYDIA SPENCER (OWNER)
(307) 679-0950
Entity
Organization
Contact information
Practice address
95 ARAPAHOE CIR, EVANSTON, WY 82930-4531
(307) 679-0950
Mailing address
PO BOX 479, EVANSTON, WY 82931-0479
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/05/2024
Last updated
08/19/2024
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