| Lauren Graham Llc | |
|
323 N Division St Powell WY 82435-2207 | |
| (307) 250-0645 | |
| (888) 247-7592 |
| Full Name | Lauren Graham Llc |
|---|---|
| Speciality | Social Worker |
| Location | 323 N Division St, Powell, Wyoming |
| Authorized Official Name and Position | Lauren Aline Graham (OWNER) |
| Authorized Official Contact | 3072500645 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lauren Graham Llc Po Box 270 Powell WY 82435-0270 Ph: (307) 250-0645 | Lauren Graham Llc 323 N Division St Powell WY 82435-2207 Ph: (307) 250-0645 |
| NPI Number | 1831680636 |
|---|---|
| Provider Enumeration Date | 05/29/2018 |
| Last Update Date | 05/29/2018 |
| Medicare PECOS PAC ID | 3870841083 |
|---|---|
| Medicare Enrollment ID | O20180803002785 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831680636 | NPI | - | NPPES |
| 142204900 | Medicaid | WY |
| Provider Name | Lauren A Graham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396961835 PECOS PAC ID: 6608174214 Enrollment ID: I20160415000460 |
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