| Magic City Enterprises, Inc | |
|
1780 Westland Rd Cheyenne WY 82001-3322 | |
| (307) 637-8869 | |
| (307) 638-0467 |
| Full Name | Magic City Enterprises, Inc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1780 Westland Rd, Cheyenne, Wyoming |
| Authorized Official Name and Position | Mandy Jane Liley (BUSINESS MANAGER) |
| Authorized Official Contact | 3076378869 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Magic City Enterprises, Inc 1780 Westland Rd Cheyenne WY 82001-3322 Ph: (307) 637-8869 | Magic City Enterprises, Inc 1780 Westland Rd Cheyenne WY 82001-3322 Ph: (307) 637-8869 |
| NPI Number | 1386819308 |
|---|---|
| Provider Enumeration Date | 04/30/2008 |
| Last Update Date | 11/17/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386819308 | NPI | - | NPPES |
| 100132911 | Medicaid | WY | |
| 100132912 | Medicaid | WY | |
| 100132901 | Medicaid | WY |
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