Organization
WYOMING EYE CARE INC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA E GLENN O.D. (PRESIDENT)
(307) 733-4905
Entity
Organization
Contact information
Practice address
110 BUFFALO WAY ST A, JACKSON, WY 83002
(307) 733-4905
(307) 733-4906
Mailing address
PO BOX 8460, JACKSON, WY 83002-8460
(307) 733-4905
(307) 733-4906
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03628
BCBS
WY
Enumeration date
02/13/2007
Last updated
02/05/2008
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