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General NPI Number Information
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NPI Number | 1750892436
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Entity Type | Organization
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Legal Business Name | COWBOY CLINIC AND URGENT CARE LLC
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Dates
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Enumeration Date | 10/20/2017
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 2001 MAIN ST
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City | TORRINGTON
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State | WY
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Zip | 82240-2708
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Country | US
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Telephone | 307-462-1054
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Fax |
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Provider Business Mailing Address
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Address Line | 108 E 20TH AVE
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City | TORRINGTON
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State | WY
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Zip | 82240-2812
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Country | US
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Telephone | 307-269-0947
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Fax | 307-459-6948
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Authorized Official
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Title or Position | CEO
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Name | SARAH JACOBSON
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Credential |
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Telephone | 307-269-0947
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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