Healthcare Provider Details

I. General information

NPI: 1932396199
Provider Name (Legal Business Name): URGENT CARE OF CASPER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2007
Last Update Date: 07/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2546 E 2ND ST #200
CASPER WY
82609-2062
US

IV. Provider business mailing address

2546 E 2ND ST #200
CASPER WY
82609-2062
US

V. Phone/Fax

Practice location:
  • Phone: 307-265-1110
  • Fax: 307-265-1108
Mailing address:
  • Phone: 307-265-1110
  • Fax: 307-265-1108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. KATHY WATSON
Title or Position: CLINIC DIRECTOR
Credential:
Phone: 307-265-1110