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General NPI Number Information
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NPI Number | 1184692584
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Entity Type | Organization
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Legal Business Name | YELLOWSTONE ULTRASOUND INC
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Dates
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Enumeration Date | 03/10/2006
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Last Update Date | 03/28/2008
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Provider Practice Location Address
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Address Line | 1021 9TH ST
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City | CODY
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State | WY
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Zip | 82414-3433
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Country | US
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Telephone | 208-667-9334
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Fax | 208-664-2341
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Provider Business Mailing Address
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Address Line | PO BOX 1358
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City | CODY
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State | WY
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Zip | 82414-1358
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Country | US
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Telephone | 208-667-9334
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Fax | 208-664-2341
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Authorized Official
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Title or Position | OWNER
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Name | LINDA BYRD
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Credential | RT
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Telephone | 307-272-4146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | GN 0769-11
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License Number State | WY
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