| Ppm Wyoming Llc | |
|
770 S Washington St Ste B Afton WY 83110-5135 | |
| (888) 253-6598 | |
| Not Available |
| Full Name | Ppm Wyoming Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 770 S Washington St Ste B, Afton, Wyoming |
| Authorized Official Name and Position | Amber Tueller (CORPORATE SECRETARY) |
| Authorized Official Contact | 2084011400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ppm Wyoming Llc 1916 N 700 W Ste 110 Layton UT 84041-5754 Ph: (385) 427-1570 | Ppm Wyoming Llc 770 S Washington St Ste B Afton WY 83110-5135 Ph: (888) 253-6598 |
| NPI Number | 1366289290 |
|---|---|
| Provider Enumeration Date | 07/09/2024 |
| Last Update Date | 07/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366289290 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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