| Banner Health Physicians Colorado Llc | |
|
201 14th St Wheatland WY 82201-3201 | |
| (307) 322-3636 | |
| Not Available |
| Full Name | Banner Health Physicians Colorado Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 201 14th St, Wheatland, Wyoming |
| Authorized Official Name and Position | Dennis E Dahlen (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 6027474000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Banner Health Physicians Colorado Llc 2901 N Central Ave Ste 160 Phoenix AZ 85012-2702 Ph: () - | Banner Health Physicians Colorado Llc 201 14th St Wheatland WY 82201-3201 Ph: (307) 322-3636 |
| NPI Number | 1689289084 |
|---|---|
| Provider Enumeration Date | 09/11/2020 |
| Last Update Date | 09/11/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689289084 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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Banner Medical Clinic Wheatland Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 14th St, Wheatland, WY 82201 Phone: 307-322-3636 Fax: 307-322-5755 |