Alta Vista Center for Integrative Medicine, LLC

NPI #1598011306 in Laramie, Wyoming

Provider Information

NPI Number: 1598011306
Entity Type: Organization
Organization Name: Alta Vista Center for Integrative Medicine, LLC
Primary Specialty: Internal Medicine
Enumeration Date: Jul 30, 2012
Last Updated: Jul 30, 2012

Practice Location

Address: 313 S 2ND ST
Address 2: SUITE B
City: Laramie
State: Wyoming
ZIP Code: 82070-3611
Phone: (307) 399-3119

Authorized Official

Name: DR. WILLIAM S. FITTERMAN, D.O.
Title: CEO/MEDICAL DIRECTOR
Phone: (307) 399-3119

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X
Internal Medicine	207R00000X	Primary

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