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General NPI Number Information
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NPI Number | 1770566200
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Entity Type | Organization
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Legal Business Name | WYOMING OSTEOPOROSIS CENTER LLC
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Dates
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Enumeration Date | 11/29/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 940 E 3RD ST STE. 106
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City | CASPER
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State | WY
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Zip | 82601-3237
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Country | US
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Telephone | 307-577-4276
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Fax | 307-577-4278
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Provider Business Mailing Address
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Address Line | 940 E 3RD ST STE. 106
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City | CASPER
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State | WY
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Zip | 82601-3237
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Country | US
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Telephone | 307-577-4276
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Fax | 307-577-4278
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | RITA GAIL ELMORE
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Credential |
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Telephone | 307-577-4276
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State | WY
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