| Jh Backcountry Health Llc | |
|
1325 S Hwy 89 Apt 108 Jackson WY 83001-8293 | |
| (307) 699-3447 | |
| (307) 939-2266 |
| Full Name | Jh Backcountry Health Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1325 S Hwy 89 Apt 108, Jackson, Wyoming |
| Authorized Official Name and Position | Tyler Ross Wright (CO-OWNER) |
| Authorized Official Contact | 3076991702 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jh Backcountry Health Llc Po Box 7916 Jackson WY 83002-7916 Ph: () - | Jh Backcountry Health Llc 1325 S Hwy 89 Apt 108 Jackson WY 83001-8293 Ph: (307) 699-3447 |
| NPI Number | 1083129944 |
|---|---|
| Provider Enumeration Date | 12/13/2017 |
| Last Update Date | 12/04/2019 |
| Medicare PECOS PAC ID | 4082057658 |
|---|---|
| Medicare Enrollment ID | O20240210000683 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083129944 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Laura Peterson Wright |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1407361355 PECOS PAC ID: 6800239476 Enrollment ID: I20240315003341 |
| Provider Name | Tyler Ross Wright |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1891200762 PECOS PAC ID: 5991148561 Enrollment ID: I20240426002737 |
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