307 Chiropractic Health Center Pc | |
5880 E 2nd St Ste 200 Casper WY 82609-4388 | |
(307) 575-2448 | |
Not Available |
Full Name | 307 Chiropractic Health Center Pc |
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Speciality | Clinic/Center |
Location | 5880 E 2nd St Ste 200, Casper, Wyoming |
Authorized Official Name and Position | Austen Wisroth (OWNER) |
Authorized Official Contact | 3075752448 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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307 Chiropractic Health Center Pc 5880 E 2nd St Ste 200 Casper WY 82609-4388 Ph: () - | 307 Chiropractic Health Center Pc 5880 E 2nd St Ste 200 Casper WY 82609-4388 Ph: (307) 575-2448 |
NPI Number | 1518324599 |
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Provider Enumeration Date | 01/22/2016 |
Last Update Date | 01/22/2016 |
Medicare PECOS PAC ID | 1850690769 |
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Medicare Enrollment ID | O20160427001812 |
Identifier | Type | State | Issuer |
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1518324599 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | 759 (Wyoming) | Primary |
Provider Name | Austen Scott Wisroth |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1275999641 PECOS PAC ID: 2769781673 Enrollment ID: I20160427001877 |
Provider Name | Luke Donald Eddington |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1982240016 PECOS PAC ID: 3072941988 Enrollment ID: I20200306001380 |
Provider Name | Clinton Low |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1235409996 PECOS PAC ID: 8527227800 Enrollment ID: I20220421000513 |
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