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General NPI Number Information
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NPI Number | 1902612971
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Entity Type | Organization
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Legal Business Name | HOSKINSON HEALTH & WELLNESS CLINIC LLC
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Dates
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Enumeration Date | 12/05/2024
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 201 W LAKEWAY RD STE 200
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City | GILLETTE
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State | WY
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Zip | 82718-6341
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Country | US
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Telephone | 307-387-9850
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Fax | 307-387-9890
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Provider Business Mailing Address
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Address Line | 201 W LAKEWAY RD STE 1004
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City | GILLETTE
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State | WY
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Zip | 82718-6349
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Country | US
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Telephone | 307-387-9850
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Fax | 307-387-9890
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Authorized Official
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Title or Position | PARTNER
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Name | WILLIAM HOSKINSON
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Credential | DO
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Telephone | 303-917-3343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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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 | 133VN1201X
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Taxonomy Name | Obesity and Weight Management Nutrition Registered Dietitian
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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 | 207QS1201X
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Taxonomy Name | Sleep Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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