Red Rock Family Practice, PC
NPI #1194792457 in Thermopolis, Wyoming
Provider Information
- NPI Number
- 1194792457
- Entity Type
- Organization
- Organization Name
- Red Rock Family Practice, PC
- Primary Specialty
- Family Medicine
- Enumeration Date
- Mar 7, 2006
- Last Updated
- Jun 7, 2012
Practice Location
- Address
- 120 N C AVE
- City
- Thermopolis
- State
- Wyoming
- ZIP Code
- 82443-2410
- Phone
- (307) 864-5534
Authorized Official
- Name
- MR. WADE TRAVIS BOMENGEN, M.D.
- Title
- OWNER
- Phone
- (307) 864-5534
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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