Healthcare Provider Details

I. General information

NPI: 1750521969
Provider Name (Legal Business Name): WYOMING NEUROMONITORING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2009
Last Update Date: 02/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 BLUEGRASS CIR 170
CHEYENNE WY
82009-7323
US

IV. Provider business mailing address

1950 BLUEGRASS CIR 170
CHEYENNE WY
82009-7323
US

V. Phone/Fax

Practice location:
  • Phone: 307-778-2860
  • Fax: 307-778-2866
Mailing address:
  • Phone: 307-778-2860
  • Fax: 307-778-2866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. STEVEN J. BEER
Title or Position: EXECUTIVE MEMBER
Credential: M.D.
Phone: 307-778-2860