Banner Medical Clinic Wheatland LLC

NPI #1568997096 in Wheatland, Wyoming

Provider Information

NPI Number
1568997096
Entity Type
Organization
Organization Name
Banner Medical Clinic Wheatland LLC
Subpart
Yes (part of a larger organization)
Parent Organization
BANNER HEALTH
Primary Specialty
Clinic/Center - Rural Health
Enumeration Date
Apr 21, 2017
Last Updated
Apr 21, 2017

Practice Location

Address
201 14TH ST
State
Wyoming
ZIP Code
82201-3201
Phone
(307) 322-3636

Authorized Official

Name
DENNIS DAHLEN
Title
SR VP FINANCE
Phone
(602) 747-4000

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Multi-SpecialtyMulti-Specialty
Clinic/Center - Rural HealthRural Health

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