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General NPI Number Information
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NPI Number | 1437922432
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Entity Type | Organization
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Legal Business Name | CLEAR EIR WELLNESS, LLC
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Dates
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Enumeration Date | 11/01/2023
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Last Update Date | 12/22/2023
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Provider Practice Location Address
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Address Line | 151 W BRUNDAGE ST
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City | SHERIDAN
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State | WY
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Zip | 82801-4217
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Country | US
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Telephone | 307-381-0544
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 284
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City | SHERIDAN
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State | WY
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Zip | 82801-0284
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Country | US
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Telephone | 307-038-1054
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Fax |
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Authorized Official
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Title or Position | OWNER/ CLINICIAN
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Name | DR. LAURIE J BROWN
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Credential | I-MD, FNP
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Telephone | 605-206-0411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 202D00000X
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Taxonomy Name | Integrative Medicine Physician
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License Number |
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License Number State |
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