| Wildroots Collective | |
|
430 B Street Bedford WY 83112-9901 | |
| (406) 212-2456 | |
| (307) 333-0843 |
| Full Name | Wildroots Collective |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 430 B Street, Bedford, Wyoming |
| Authorized Official Name and Position | Karelia Mowbray (OWNER) |
| Authorized Official Contact | 4062122456 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wildroots Collective Po Box 2829 Alpine WY 83128-2608 Ph: () - | Wildroots Collective 430 B Street Bedford WY 83112-9901 Ph: (406) 212-2456 |
| NPI Number | 1538947353 |
|---|---|
| Provider Enumeration Date | 09/21/2023 |
| Last Update Date | 09/21/2023 |
| Certification Date | 09/20/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538947353 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |