Organization
SOUTHWEST PAIN MANAGEMENT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRANDON VASHON MACK MD (PRESIDENT)
(307) 362-1444
Entity
Organization
Contact information
Practice address
1200 COLLEGE DR, ROCK SPRINGS, WY 82901-5868
(307) 325-8329
Mailing address
PO BOX 3228, ROCK SPRINGS, WY 82902-3228
(307) 362-1444
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
7706A
WY
Other
Enumeration date
09/30/2011
Last updated
09/30/2011
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