| Ciara Coral Llc | |
|
433 E 19th St Cheyenne WY 82001-4991 | |
| (307) 426-4021 | |
| Not Available |
| Full Name | Ciara Coral Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 433 E 19th St, Cheyenne, Wyoming |
| Authorized Official Name and Position | Ryan Ackerman (DIRECTOR) |
| Authorized Official Contact | 3074264021 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ciara Coral Llc 433 E 19th St Cheyenne WY 82001-4991 Ph: () - | Ciara Coral Llc 433 E 19th St Cheyenne WY 82001-4991 Ph: (307) 426-4021 |
| NPI Number | 1245918978 |
|---|---|
| Provider Enumeration Date | 07/11/2023 |
| Last Update Date | 10/17/2023 |
| Certification Date | 10/17/2023 |
| Medicare PECOS PAC ID | 9133563661 |
|---|---|
| Medicare Enrollment ID | O20240222003707 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245918978 | NPI | - | NPPES |
| Provider Name | Ryan Wayne Ackerman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679838056 PECOS PAC ID: 2860836392 Enrollment ID: I20240222003788 |
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