Healthcare Provider Details

I. General information

NPI: 1215840236
Provider Name (Legal Business Name): BE WELL HEALTH AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 N SCOTT ST STE D
SHERIDAN WY
82801-3960
US

IV. Provider business mailing address

117 N SCOTT ST STE D
SHERIDAN WY
82801-3960
US

V. Phone/Fax

Practice location:
  • Phone: 307-667-1400
  • Fax:
Mailing address:
  • Phone: 307-667-1400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AMANDA M MCINTIRE
Title or Position: OWNER/PROVIDER
Credential:
Phone: 307-840-0595