Organization
WESTERN WYOMING MEDICAL CLINICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIDGETT HOWARD (BILLING OFFICE)
(307) 206-1224
Entity
Organization
Contact information
Practice address
535 E MAIN ST STE B, LANDER, WY 82520-3410
(307) 206-1224
(307) 206-1214
Mailing address
PO BOX 26950, BELFAST, ME 04915-2020
(307) 206-1224
(307) 206-1214
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152503400
—
WY
Enumeration date
11/13/2019
Last updated
06/25/2021
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