| Anova Med Spa LLC | |
|
1415 N Main St Sheridan WY 82801-2629 | |
| (307) 752-1849 | |
| Not Available |
| Full Name | Anova Med Spa LLC |
|---|---|
| Speciality | Clinic/center |
| Location | 1415 N Main St, Sheridan, Wyoming |
| Authorized Official Name and Position | Cheyloh Bluemel (MANAGER) |
| Authorized Official Contact | 3074610845 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Anova Med Spa LLC 1125 Leopard St Sheridan WY 82801-4627 Ph: (307) 752-1849 | Anova Med Spa LLC 1415 N Main St Sheridan WY 82801-2629 Ph: (307) 752-1849 |
| NPI Number | 1992527683 |
|---|---|
| Provider Enumeration Date | 10/24/2024 |
| Last Update Date | 04/03/2025 |
| Certification Date | 04/03/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992527683 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| 261QP2300X | Clinic/center - Primary Care | () | Secondary |
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