| Organization Name: | WYOMING FAMILY SONOGRAPHY, LLC |
| NPI Number: | 1144660044 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | FAITH BENNIGAN HAMILTON (PRESIDENT) |
| Mailing Address: | 755 Wood St Lander |
| State: | WY US |
| Postal Code: | 825202155 |
| Phone Number: | 3074389844 |
| Fax Number: | |
| NPI Enumeration Date: | 06/25/2013 |
| NPI Last Update Date: | 10/30/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2471V0105X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WY |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Radiologic Technologist |
| Taxonomy Specialization: | Vascular Sonography |
| Taxonomy Definition: | |