| Optimal Performance Medicine, Llc | |
|
611 E Carlson St Ste 117c Cheyenne WY 82009-4311 | |
| (307) 514-0510 | |
| Not Available |
| Full Name | Optimal Performance Medicine, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 611 E Carlson St Ste 117c, Cheyenne, Wyoming |
| Authorized Official Name and Position | Paul Jordan Washburn (DIRECTOR/OWNER) |
| Authorized Official Contact | 9705189394 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Optimal Performance Medicine, Llc 611 E Carlson St Ste 117c Cheyenne WY 82009-4311 Ph: (307) 514-0510 | Optimal Performance Medicine, Llc 611 E Carlson St Ste 117c Cheyenne WY 82009-4311 Ph: (307) 514-0510 |
| NPI Number | 1659911550 |
|---|---|
| Provider Enumeration Date | 01/09/2020 |
| Last Update Date | 01/09/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659911550 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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