University of Wyoming
NPI #1316340417 in Pine Bluffs, Wyoming
Provider Information
- NPI Number
- 1316340417
- Entity Type
- Organization
- Organization Name
- University of Wyoming
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- UNIVERSITY OF WYOMING
- Primary Specialty
- Clinic/Center - Federally Qualified Health Center (FQHC)
- Enumeration Date
- Oct 2, 2014
- Last Updated
- Apr 13, 2016
Practice Location
- Address
- 117 E 4TH ST
- City
- Pine Bluffs
- State
- Wyoming
- ZIP Code
- 82082
- Phone
- (307) 245-3666
Authorized Official
- Name
- RONALD MALM, MD
- Title
- PROGRAM DIRECTOR
- Phone
- (307) 632-2434
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center |
| Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC) |
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