| Grand Ave Family Medicine | |
|
3236 E Grand Ave Ste D Laramie WY 82070-5100 | |
| (970) 231-3498 | |
| Not Available |
| Full Name | Grand Ave Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 3236 E Grand Ave Ste D, Laramie, Wyoming |
| Authorized Official Name and Position | John Jacobs (OWNER) |
| Authorized Official Contact | 9702313498 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grand Ave Family Medicine 3236 E Grand Ave Ste D Laramie WY 82070-5100 Ph: (970) 231-3498 | Grand Ave Family Medicine 3236 E Grand Ave Ste D Laramie WY 82070-5100 Ph: (970) 231-3498 |
| NPI Number | 1437842390 |
|---|---|
| Provider Enumeration Date | 05/29/2023 |
| Last Update Date | 05/29/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437842390 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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