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General NPI Number Information
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NPI Number | 1851410682
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Entity Type | Organization
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Legal Business Name | LARAMIE REPRODUCTIVE HEALTH
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 07/09/2018
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Provider Practice Location Address
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Address Line | 1252 N 22ND ST SUITE A
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City | LARAMIE
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State | WY
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Zip | 82072
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Country | US
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Telephone | 307-745-5364
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Fax | 307-745-4164
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Provider Business Mailing Address
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Address Line | 1252 N 22ND ST SUITE A
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City | LARAMIE
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State | WY
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Zip | 82072
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Country | US
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Telephone | 307-745-5364
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Fax | 307-745-4164
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Authorized Official
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Title or Position | EXEC DIRECTOR
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Name | MATTHEW MILLER
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Credential |
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Telephone | 307-745-4364
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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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 | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State | WY
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