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General NPI Number Information
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NPI Number | 1306700588
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Entity Type | Organization
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Legal Business Name | WYCO DERM LLC
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Dates
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Enumeration Date | 12/12/2025
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 5451 E. HARMONY BUILDING 2 UNIT 109
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City | TIMNATH
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State | CO
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Zip | 82001-3830
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Country | US
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Telephone | 307-635-8299
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Fax | 307-635-6984
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Provider Business Mailing Address
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Address Line | 2112 SEYMOUR AVE
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City | CHEYENNE
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State | WY
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Zip | 82001-3830
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Country | US
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Telephone | 307-635-8299
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Fax | 307-635-6984
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Authorized Official
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Title or Position | OWNER
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Name | GREGORY SEITZ
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Credential |
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Telephone | 307-635-8299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207NI0002X
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Taxonomy Name | Clinical & Laboratory Dermatological Immunology Physician
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License Number |
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License Number State |
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