Organization Name: | NORTHERN WYOMING OPHTHALMOLOGY, P.C. |
NPI Number: | 1124220645 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BARRY P. WELCH (OWNER) |
Mailing Address: | 424 Yellowstone Ave Suite 110 Cody |
State: | WY US |
Postal Code: | 824143423 |
Phone Number: | 3075875788 |
Fax Number: | 3075874896 |
NPI Enumeration Date: | 06/05/2007 |
NPI Last Update Date: | 03/21/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |