Organization
CLEAR IMAGE LASER STUDIO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA SUE MOSHER FNP (FNP)
(307) 259-2434
Entity
Organization
Contact information
Practice address
532 VAL VISTA ST, SUITE 104, SHERIDAN, WY 82801-3655
(307) 655-8289
(307) 655-8291
Mailing address
532 VAL VISTA ST, SUITE 104, SHERIDAN, WY 82801-3655
(307) 655-8289
(307) 655-8291
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
9206-1081
WY
Other
Enumeration date
06/04/2013
Last updated
06/04/2013
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