Bear River Urology, Llc

NPI 1063708592 - Urology - 208800000X

NPI Details
NPI 1063708592
Enumeration Date 06/23/2011
Last Updated 06/23/2011
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name MICHAEL E MICHAEL
Position OWNER
Phone (307) 789-8721
Fax
Practice Location
196 ARROWHEAD DR
SUITE #4
EVANSTON WY, 82930-8752, US
Phone (307) 789-8721
Fax
Business Location
196 ARROWHEAD DR
SUITE #4
EVANSTON WY, 82930-8752, US
Phone (307) 789-8721
Fax
Toxanomy
Taxonomy Code 208800000X
License State Wyoming
License Number TL#1572
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According to our database, Bear River Urology, Llc NPI is 1063708592, taxonomy code is 208800000X and license number is TL#1572, license state is located at Wyoming. Bear River Urology, Llc physically located at 196 Arrowhead Dr, Evanston WY, 82930-8752. NPI Number 1033115704 has the healthcare provider type.

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1063708592 NPI number is provided on an as is basis without warranty of any kind. 1063708592 is maintained by the National Plan & Provider Enumeration System. The contents of Bear River Urology, Llc are for informational purposes only.