Goose Creek Family Practice, P.c.

NPI #1134407356 in Sheridan, Wyoming

Provider Information

NPI Number
1134407356
Entity Type
Organization
Organization Name
Goose Creek Family Practice, P.c.
Primary Specialty
Clinic/Center
Enumeration Date
Jul 22, 2011
Last Updated
Nov 9, 2012

Practice Location

Address
304 COFFEEN AVE
Address 2
SUITE A
State
Wyoming
ZIP Code
82801-4803
Phone
(307) 674-1744

Authorized Official

Name
MS. DEBRA ANN KAWULOK, FNP-C
Title
PRESIDENT
Phone
(307) 674-1744

Specialties & Taxonomy Codes

Specialty
Clinic/Center

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