Organization Name: | STRONG TREE CLINIC |
NPI Number: | 1750457933 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOSEPH BAUMSTARCK (DOCTOR) |
Mailing Address: | 342 E Main St Lovell |
State: | WY US |
Postal Code: | 824312136 |
Phone Number: | 3075486289 |
Fax Number: | 3075486910 |
NPI Enumeration Date: | 11/28/2006 |
NPI Last Update Date: | 06/18/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR1300X |
License Number: | 5460A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WY |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rural Health |
Taxonomy Definition: |