Healthcare Provider Details

I. General information

NPI: 1760306567
Provider Name (Legal Business Name): DOWNTOWN CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 S 2ND ST
LARAMIE WY
82070-3617
US

IV. Provider business mailing address

611 S 2ND ST
LARAMIE WY
82070-3617
US

V. Phone/Fax

Practice location:
  • Phone: 307-745-8445
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: PETE GOSAR
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 307-745-8445