Ppm Wyoming LLC

NPI #1366289290 in Afton, Wyoming

Provider Information

NPI Number
1366289290
Entity Type
Organization
Organization Name
Ppm Wyoming LLC
Primary Specialty
Clinic/Center - Multi-Specialty
Enumeration Date
Jul 9, 2024
Last Updated
Jul 9, 2024

Practice Location

Address
770 S WASHINGTON ST STE B
City
Afton
State
Wyoming
ZIP Code
83110-5135
Phone
(888) 253-6598

Authorized Official

Name
AMBER TUELLER
Title
CORPORATE SECRETARY
Phone
(208) 401-1400

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Multi-SpecialtyMulti-Specialty

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